Caesarean section in severe preeclampsia: features of early neonatal adaptation

Objective. To study the course of early neonatal adaptation depending on the anesthetic aid in abdominaldelivery of pregnant women with severe preeclampsia. Characteristic o fchildren and research methods. Thea uthorscarried outaprospective cohort study o f342 childrenborn from mothers with severepreeclampsia. The children were grouped according to their gestationalage. The author sanalyzed perinatallosse sand assessed general condition according to the Apgarscaleat the 1st and 5th minutes of life, aswell as the neurological status of newborns according to the NACS scale at the 15thminute of life and in 2 hours depending on the anesthesia method used during the caesareansection.Results. The authors found that the newborns from mothers with severe preeclampsia, starting from the 34th week of gestation, demonstrated a significantly more pronounced negative effect of total intravenous anesthesia on their somatic (birth in a state of hypoxia) and neurological status as compared with spinalanesthesia (р<0,05). ><0,05).Conclusion. The results are of practical value to neonatologists, as total intravenous anesthesia is expectedto causethe revealed violations of the adaptive ability of newborns and the doctor is able to provide adequate timely assistance to children.

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Technical and clinical evaluation of a closed loop TIVA system with SEDLineTM spectral density monitoring: Multicentric prospective cohort study

Perioperative Medicine ◽

10.1186/s13741-019-0130-2 ◽

2020 ◽

Vol 9 (1) ◽

Cited By ~ 1

Author(s):

Claudia Castellanos Peñaranda ◽

Fabián D. Casas Arroyave ◽

Francisco J. Gómez ◽

Paola A. Pinzón Corredor ◽

Juan M. Fernández ◽

...

Keyword(s):

Cohort Study ◽

Prospective Cohort ◽

Closed Loop ◽

Clinical Performance ◽

Total Intravenous Anesthesia ◽

Closed Loop System ◽

Intravenous Anesthesia ◽

Anesthetic Depth ◽

Maintenance Time ◽

Performance Error

Abstract Introduction Closed loop total intravenous anesthesia is a technique in which the patient’s hemodynamic and anesthetic depth variables are monitored, and based on this information, a computer controls the infusion rate of drugs to keep them within pre-established clinical parameters. Objective To describe the technical and clinical performance of a closed loop system for total intravenous anesthesia with propofol and remifentanil, using the SEDLineTM monitor Design Multicentric prospective cohort study Setting Surgery room Patients ASA I-II undergoing elective surgery Measurements The authors designed a closed loop system that implements a control algorithm based on anesthetic depth monitoring and the Patient State Index (PSITM) of the SEDLine monitor for propofol, and on hemodynamic variables for remifentanil. The measurement of clinical performance was made based on the percentage of PSITM maintenance time in the range 20–50. Precision analysis was evaluated by measuring median performance error (MDPE) can be defined as the median difference between actual and desired values, which refers to the degree of precision in which the controller is able to maintain the control variable within the objective set by the anesthesiologist; it represents the direction (over-prediction or under-prediction) of performance error (PE) rather than size of errors, which is represented by MDAPE, median absolute percentage error, Wobble index, which is used for measuring the intrasubject variability in performance error. Results Data were obtained from 93 patients in three healthcare centers. The percentage of PSITM maintenance time in the 20–50 range was 92% (80.7–97.0). MDPE was 10.7 (− 11.0–18.0), MDAPE 21.0 (14.2–26.8) and wobble 10.7 (7.0–16.9). No adverse surgical or anesthetic events were found. Conclusions The closed loop total intravenous anesthesia system with SEDLine developed by the authors was used without major complication and appear to be feasible its use in clinical performance.

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