Feasibility of continuous high-resolution bioreactance monitoring during cesarean delivery under spinal anesthesia
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Frontiers
Abstract
Purpose: This study is the first to apply bioreactance-based hemodynamic
monitoring with a 4-s interval during cesarean delivery under spinal anesthesia.
We evaluated the feasibility of continuous, high-resolution perioperative
monitoring in a routine clinical setting, with a particular focus on the temporal
relationship between hypotension and changes in advanced hemodynamic
parameters.
Methods: This prospective observational study conducted between December
2023 and April 2024 included 51 healthy parturients scheduled for elective
cesarean delivery under spinal anesthesia were included. All participants
underwent continuous non-invasive hemodynamic monitoring using
bioreactance technology. Hemodynamic parameters were recorded at 4-s
intervals. The primary outcome was the relative change in the stroke volume
index (SVI) from baseline. The secondary endpoints included signal quality, data
integrity, and trends in hemodynamic parameters.
Results: A reduction in the stroke volume index (SVI) of ≥20% was observed
in 29 of 51 patients. The median percentage change in SVI from baseline
was −18.9% [IQR − 31.5 to −6.1]; p < 0.001. The median time from the onset
of relevant SVI decline to the occurrence of hypotension was 2:20 min [IQR
1:16–3:56]. The total cumulative observation time for all patients was 3,781 min.
At a 4-s sampling interval, approximately 56,713 data points per hemodynamic
parameter were expected. The signal loss was minimal, with less than 0.5%
missing data per parameter.
Conclusion: This method proved to be feasible and yielded stable, highresolution
hemodynamic data. Among all parameters, SVI showed the most
consistent baseline values prior to anesthesia. It also demonstrated the most
pronounced change, with a statistically significant decline in the majority of
subjects between spinal anesthesia and the onset of first hypotension. In such
cases, the marked decline in SVI may serve as an early indicator of impending
hemodynamic compromise. These results from a low-risk obstetric cohort may
inform future research on high-risk populations.
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Except where otherwise noted, this item's license is described as Attribution 4.0 International