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dc.contributor.authorSharwood-Smith, Geoffrey H.
dc.contributor.authorBruce, J.
dc.contributor.authorDrummond, G.
dc.date.accessioned2011-04-13T10:19:58Z
dc.date.available2011-04-13T10:19:58Z
dc.date.issued2006-01
dc.identifier.citationSharwood-Smith, G., Bruce, J. and Drummond, G. 2006. Assessment of pulse transit time to indicate cardiovascular changes during obstetric spinal anaesthesia. British Journal of Anaesthesia. 96(1): 100-105en_US
dc.identifier.issn0007-0912en_US
dc.identifier.issn1471-6771en_US
dc.identifier.urihttps://hdl.handle.net/10023/1815en_US
dc.identifier.urihttps://hdl.handle.net/10023/1822
dc.descriptionPart of the Portfolio Thesis by Geoffrey H. Sharwood-Smith: The inferior vena caval compression theory of hypotension in obstetric spinal anaesthesia: studies in normal and preeclamptic pregnancy, a literature review and revision of fundamental concepts, available at http://hdl.handle.net/10023/1815en_US
dc.description.abstractBackground. Pulse transit time (PTT) measurement may provide rapidly available beat-to-beat cardiovascular information when conditions change quickly and routine invasive arterial pressure measurement is not justified, for example during obstetric spinal anaesthesia. Method. We obtained ethics approval for an observational study of PTT during the onset of spinal anaesthesia in patients having elective or urgent Caesarean section. PTT was measured as the difference in time between the peak of the ECG R wave and the upstroke of the toe plethysmograph. Arterial pressure was measured by non-invasive sphygmomanometry. Results. We analysed data from 58 normotensive patients and 15 patients with pregnancy-induced hypertension (PIH). PTT increased with the onset of spinal anaesthesia as arterial pressure decreased. An increase of 20% in PTT was 74% sensitive and 70% specific in indicating a decrease in mean arterial pressure of more than 10%. Changes in PTT were related to changes in mean arterial pressure (r2=0.55, P<0.0001). Arterial pressure changes were greater and PTT increased significantly more quickly in the normotensive patients than in the patients with hypertension [median, quartiles: 32 (14, 56) ms min−1 compared with 7 (6, 18) ms min−1; P<0.01, Mann–Whitney U-test]. However, the relationship between PTT and arterial pressure was similar for the normotensive patients and the patients with PIH. Conclusion. PTT measurement gave a beat-to-beat indication of arterial pressure during spinal anaesthesia, and could be developed to allow prediction of the onset of hypotension.en_US
dc.format.extent6
dc.language.isoenen_US
dc.publisherOxford University Pressen_US
dc.relationSharwood-Smith, Geoffrey H. 2011. The inferior vena caval compression theory of hypotension in obstetric spinal anaesthesia: studies in normal and preeclamptic pregnancy, a literature review and revision of fundamental concepts [Thesis]. University of St Andrewsen_US
dc.relation.ispartofBritish Journal of Anaesthesiaen_US
dc.relation.ispartofThe inferior vena caval compression theory of hypotension in obstetric spinal anaesthesia: studies in normal and preeclamptic pregnancy, a literature review and revision of fundamental conceptsen_US
dc.rights© The Board of Management and Trustees of the British Journal of Anaesthesia 2005. Deposited as part of portfolio thesis by permission of the publisher.en_US
dc.subjectAnaesthesiaen_US
dc.subjectSpinal anaesthesiaen_US
dc.subjectAnaesthetic techniquesen_US
dc.subjectCardiovascular systemen_US
dc.subjectPulse transit timeen_US
dc.subjectPregnancyen_US
dc.subject.lccRGen_US
dc.subject.lcshAnesthesia in obstetricsen_US
dc.titleAssessment of pulse transit time to indicate cardiovascular changes during obstetric spinal anaesthesiaen_US
dc.typeJournal articleen_US
dc.description.versionPublisher PDFen_US
dc.publicationstatusPublisheden_US
dc.statusPeer revieweden_US
dc.identifier.doihttp://dx.doi.org/10.1093/bja/aei266
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