Future blood pressure monitoring for cesarean delivery
- 286 Downloads
KeywordsBlood pressure Cesarean delivery Spinal anesthesia
To the Editor:
I read with interest the study by Juri et al.  regarding hemodynamic monitoring for cesarean delivery. I would like to discuss the implication of the study and future prediction.
Juri et al. concluded that using ClearSight™ had fewer incidence of maternal hypotension than conventional non-invasive blood pressure monitoring. I assume that the study showed the clinical benefit of using continuous monitoring, not the device. Continuous monitoring is theoretically ideal; however, the routine application to all cesarean patients is not feasible, including the costs, and cannot be justified by the current evidence . Systolic blood pressure (SBP) is commonly considered as a parameter reflecting organ perfusion, but it is less meaningful than mean arterial pressure (MAP) . Although MAP sounds physiologically reasonable and the recent experts’ opinions support the importance , there are no well-designed studies. We conducted a retrospective study and found minimum MAP < 70 mmHg and longer duration of SBP < 100 mmHg were related to lower umbilical arterial pH . Not only value but also duration of hypotension is of importance.
Compliance with ethical standards
Conflict of interest
The author declares that he has no interests to disclose.
- 2.Kinsella SM, Carvalho B, Dyer RA, Fernando R, McDonnell N, Mercier FJ, Palanisamy A, Sia ATH, Van de Velde M, Vercueil A. International consensus statement on the management of hypotension with vasopressors during caesarean section under spinal anaesthesia. Anaesthesia. 2018;73:71–92.CrossRefGoogle Scholar
- 3.McGhee BH, Bridge EJ. Monitoring arterial blood pressure: what you may not know. Crit Care Nurse. 2002;22:60–79.Google Scholar
- 4.Mazda Y, Terui K, Tanaka M, Tamura K. Does maternal mean arterial pressure predict fetal acidemia better than systolic blood pressure during spinal anesthesia for cesarean delivery? J Saitama Med Univ. 2016;42:131–7.Google Scholar