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Hypotension after spinal anesthesia for cesarean section: identification of risk factors using an anesthesia information management system
Objective. To determine risk factors for developing hypotension after spinal anesthesia for cesarean section to prevent obstetric patients from hypotensive episodes potentially resulting in intrauterine malperfusion and endangering the child. Methods. The data from 503 women, having received spinal...
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Published in: | Journal of clinical monitoring and computing 2009-04, Vol.23 (2), p.85-92 |
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container_title | Journal of clinical monitoring and computing |
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creator | Brenck, F. Hartmann, B. Katzer, C. Obaid, R. Brüggmann, D. Benson, M. Röhrig, R. Junger, A. |
description | Objective.
To determine risk factors for developing hypotension after spinal anesthesia for cesarean section to prevent obstetric patients from hypotensive episodes potentially resulting in intrauterine malperfusion and endangering the child.
Methods.
The data from 503 women, having received spinal anesthesia for cesarean sections were investigated using online gathered vital signs and specially checked manual entries employing an anesthesia information management system. Blood pressure, heart rate, and oxygen saturation were measured throughout and hypotension was defined as either a drop in mean arterial blood pressure of >20% from baseline value or readings of |
doi_str_mv | 10.1007/s10877-009-9168-x |
format | article |
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To determine risk factors for developing hypotension after spinal anesthesia for cesarean section to prevent obstetric patients from hypotensive episodes potentially resulting in intrauterine malperfusion and endangering the child.
Methods.
The data from 503 women, having received spinal anesthesia for cesarean sections were investigated using online gathered vital signs and specially checked manual entries employing an anesthesia information management system. Blood pressure, heart rate, and oxygen saturation were measured throughout and hypotension was defined as either a drop in mean arterial blood pressure of >20% from baseline value or readings of <90 mmHg systolic arterial blood pressure. Thirty-two variables were studied for association with hypotensive episodes using univariate analysis and logistic regression employing a forward stepwise algorithm to identify independent variables (
P
< 0.05).
Results.
Hypotension was found in 284 cases (56.5%). The univariate analysis identified the neonate’s weight, mother’s age, body mass index, and peak sensory block height associated with hypotension. Body mass index, age and sensory block height were detected as independent factors for hypotension (odds-ratio: 1.61 each).
Conclusions.
Knowledge of these risk factors should increase the anesthesiologist’s attention to decide for the necessity to employ prophylactic or therapeutic techniques or drugs to prevent the neonate from any risk resulting of hypotension of the mother.</description><identifier>ISSN: 1387-1307</identifier><identifier>EISSN: 1573-2614</identifier><identifier>DOI: 10.1007/s10877-009-9168-x</identifier><identifier>PMID: 19277879</identifier><identifier>CODEN: JCMCFG</identifier><language>eng</language><publisher>Dordrecht: Springer Netherlands</publisher><subject>Adult ; Age Factors ; Algorithms ; Anesthesia, Spinal - adverse effects ; Anesthesiology ; Blood Pressure - physiology ; Body Mass Index ; Cesarean Section - methods ; Critical Care Medicine ; Female ; Health Sciences ; Heart Rate - physiology ; Humans ; Hypotension - chemically induced ; Hypotension - epidemiology ; Hypotension - physiopathology ; Intensive ; Logistic Models ; Management Information Systems ; Medicine ; Medicine & Public Health ; Pregnancy ; Retrospective Studies ; Risk Factors ; Statistics for Life Sciences ; Young Adult</subject><ispartof>Journal of clinical monitoring and computing, 2009-04, Vol.23 (2), p.85-92</ispartof><rights>Springer Science+Business Media, LLC 2009</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c400t-fef2fc2793cceed51d7d7569658aa7dcb7a89783d07370a141f44524f6c467463</citedby><cites>FETCH-LOGICAL-c400t-fef2fc2793cceed51d7d7569658aa7dcb7a89783d07370a141f44524f6c467463</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19277879$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Brenck, F.</creatorcontrib><creatorcontrib>Hartmann, B.</creatorcontrib><creatorcontrib>Katzer, C.</creatorcontrib><creatorcontrib>Obaid, R.</creatorcontrib><creatorcontrib>Brüggmann, D.</creatorcontrib><creatorcontrib>Benson, M.</creatorcontrib><creatorcontrib>Röhrig, R.</creatorcontrib><creatorcontrib>Junger, A.</creatorcontrib><title>Hypotension after spinal anesthesia for cesarean section: identification of risk factors using an anesthesia information management system</title><title>Journal of clinical monitoring and computing</title><addtitle>J Clin Monit Comput</addtitle><addtitle>J Clin Monit Comput</addtitle><description>Objective.
To determine risk factors for developing hypotension after spinal anesthesia for cesarean section to prevent obstetric patients from hypotensive episodes potentially resulting in intrauterine malperfusion and endangering the child.
Methods.
The data from 503 women, having received spinal anesthesia for cesarean sections were investigated using online gathered vital signs and specially checked manual entries employing an anesthesia information management system. Blood pressure, heart rate, and oxygen saturation were measured throughout and hypotension was defined as either a drop in mean arterial blood pressure of >20% from baseline value or readings of <90 mmHg systolic arterial blood pressure. Thirty-two variables were studied for association with hypotensive episodes using univariate analysis and logistic regression employing a forward stepwise algorithm to identify independent variables (
P
< 0.05).
Results.
Hypotension was found in 284 cases (56.5%). The univariate analysis identified the neonate’s weight, mother’s age, body mass index, and peak sensory block height associated with hypotension. Body mass index, age and sensory block height were detected as independent factors for hypotension (odds-ratio: 1.61 each).
Conclusions.
Knowledge of these risk factors should increase the anesthesiologist’s attention to decide for the necessity to employ prophylactic or therapeutic techniques or drugs to prevent the neonate from any risk resulting of hypotension of the mother.</description><subject>Adult</subject><subject>Age Factors</subject><subject>Algorithms</subject><subject>Anesthesia, Spinal - adverse effects</subject><subject>Anesthesiology</subject><subject>Blood Pressure - physiology</subject><subject>Body Mass Index</subject><subject>Cesarean Section - methods</subject><subject>Critical Care Medicine</subject><subject>Female</subject><subject>Health Sciences</subject><subject>Heart Rate - physiology</subject><subject>Humans</subject><subject>Hypotension - chemically induced</subject><subject>Hypotension - epidemiology</subject><subject>Hypotension - physiopathology</subject><subject>Intensive</subject><subject>Logistic Models</subject><subject>Management Information Systems</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Pregnancy</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Statistics for Life Sciences</subject><subject>Young Adult</subject><issn>1387-1307</issn><issn>1573-2614</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><recordid>eNp1kU1v1DAQhi0Eoh_wA7ggiwO3UH8lk3BDFVCkSr2Us-U648VlYy-eROr-BX51vcpKrZA42ZafeWY0L2PvpPgkhYALkqIHaIQYmkF2ffPwgp3KFnSjOmle1rvuoZFawAk7I7oXFey1fM1O5KAAehhO2d-r_S7PmCjmxF2YsXDaxeS23CWk-RdSdDzkwj2SK-gSJ_RzhT_zOGKaY4jeHd48B14i_ebB-TkX4gvFtKmW56KYqmpa-cklt8GpOjjtacbpDXsV3Jbw7fE8Zz-_fb29vGqub77_uPxy3XgjxNwEDCp4BYP2HnFs5QgjtN3Qtb1zMPo7cP0AvR4FaBBOGhmMaZUJnTcdmE6fs4-rd1fyn6XOZqdIHrfbOmheyGqjZNuZoYIf_gHv81LqbsgqCVKrSlVIrpAvmahgsLsSJ1f2Vgp7SMmuKdm6fHtIyT7UmvdH8XI34fhUcYylAmoFqH6lDZanzv-3PgLImKEQ</recordid><startdate>20090401</startdate><enddate>20090401</enddate><creator>Brenck, F.</creator><creator>Hartmann, B.</creator><creator>Katzer, C.</creator><creator>Obaid, R.</creator><creator>Brüggmann, D.</creator><creator>Benson, M.</creator><creator>Röhrig, R.</creator><creator>Junger, A.</creator><general>Springer Netherlands</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7SC</scope><scope>7SP</scope><scope>7U5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>JQ2</scope><scope>K7-</scope><scope>K9.</scope><scope>KB0</scope><scope>L7M</scope><scope>L~C</scope><scope>L~D</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope></search><sort><creationdate>20090401</creationdate><title>Hypotension after spinal anesthesia for cesarean section: identification of risk factors using an anesthesia information management system</title><author>Brenck, F. ; Hartmann, B. ; Katzer, C. ; Obaid, R. ; Brüggmann, D. ; Benson, M. ; Röhrig, R. ; Junger, A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c400t-fef2fc2793cceed51d7d7569658aa7dcb7a89783d07370a141f44524f6c467463</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Adult</topic><topic>Age Factors</topic><topic>Algorithms</topic><topic>Anesthesia, Spinal - adverse effects</topic><topic>Anesthesiology</topic><topic>Blood Pressure - physiology</topic><topic>Body Mass Index</topic><topic>Cesarean Section - methods</topic><topic>Critical Care Medicine</topic><topic>Female</topic><topic>Health Sciences</topic><topic>Heart Rate - physiology</topic><topic>Humans</topic><topic>Hypotension - chemically induced</topic><topic>Hypotension - epidemiology</topic><topic>Hypotension - physiopathology</topic><topic>Intensive</topic><topic>Logistic Models</topic><topic>Management Information Systems</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Pregnancy</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Statistics for Life Sciences</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Brenck, F.</creatorcontrib><creatorcontrib>Hartmann, B.</creatorcontrib><creatorcontrib>Katzer, C.</creatorcontrib><creatorcontrib>Obaid, R.</creatorcontrib><creatorcontrib>Brüggmann, D.</creatorcontrib><creatorcontrib>Benson, M.</creatorcontrib><creatorcontrib>Röhrig, R.</creatorcontrib><creatorcontrib>Junger, A.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Computer and Information Systems Abstracts</collection><collection>Electronics & Communications Abstracts</collection><collection>Solid State and Superconductivity Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Computer Science Collection</collection><collection>Computer science database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Advanced Technologies Database with Aerospace</collection><collection>Computer and Information Systems Abstracts Academic</collection><collection>Computer and Information Systems Abstracts Professional</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest advanced technologies & aerospace journals</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><jtitle>Journal of clinical monitoring and computing</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Brenck, F.</au><au>Hartmann, B.</au><au>Katzer, C.</au><au>Obaid, R.</au><au>Brüggmann, D.</au><au>Benson, M.</au><au>Röhrig, R.</au><au>Junger, A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Hypotension after spinal anesthesia for cesarean section: identification of risk factors using an anesthesia information management system</atitle><jtitle>Journal of clinical monitoring and computing</jtitle><stitle>J Clin Monit Comput</stitle><addtitle>J Clin Monit Comput</addtitle><date>2009-04-01</date><risdate>2009</risdate><volume>23</volume><issue>2</issue><spage>85</spage><epage>92</epage><pages>85-92</pages><issn>1387-1307</issn><eissn>1573-2614</eissn><coden>JCMCFG</coden><abstract>Objective.
To determine risk factors for developing hypotension after spinal anesthesia for cesarean section to prevent obstetric patients from hypotensive episodes potentially resulting in intrauterine malperfusion and endangering the child.
Methods.
The data from 503 women, having received spinal anesthesia for cesarean sections were investigated using online gathered vital signs and specially checked manual entries employing an anesthesia information management system. Blood pressure, heart rate, and oxygen saturation were measured throughout and hypotension was defined as either a drop in mean arterial blood pressure of >20% from baseline value or readings of <90 mmHg systolic arterial blood pressure. Thirty-two variables were studied for association with hypotensive episodes using univariate analysis and logistic regression employing a forward stepwise algorithm to identify independent variables (
P
< 0.05).
Results.
Hypotension was found in 284 cases (56.5%). The univariate analysis identified the neonate’s weight, mother’s age, body mass index, and peak sensory block height associated with hypotension. Body mass index, age and sensory block height were detected as independent factors for hypotension (odds-ratio: 1.61 each).
Conclusions.
Knowledge of these risk factors should increase the anesthesiologist’s attention to decide for the necessity to employ prophylactic or therapeutic techniques or drugs to prevent the neonate from any risk resulting of hypotension of the mother.</abstract><cop>Dordrecht</cop><pub>Springer Netherlands</pub><pmid>19277879</pmid><doi>10.1007/s10877-009-9168-x</doi><tpages>8</tpages></addata></record> |
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source | Springer Nature |
subjects | Adult Age Factors Algorithms Anesthesia, Spinal - adverse effects Anesthesiology Blood Pressure - physiology Body Mass Index Cesarean Section - methods Critical Care Medicine Female Health Sciences Heart Rate - physiology Humans Hypotension - chemically induced Hypotension - epidemiology Hypotension - physiopathology Intensive Logistic Models Management Information Systems Medicine Medicine & Public Health Pregnancy Retrospective Studies Risk Factors Statistics for Life Sciences Young Adult |
title | Hypotension after spinal anesthesia for cesarean section: identification of risk factors using an anesthesia information management system |
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