CLINICAL TRIAL article
Front. Med.
Sec. Intensive Care Medicine and Anesthesiology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1421947
Effect of Combined Colloid preloading and crystalloid coloading Versus Combined Colloid and crystalloid coloading on Maternal Cardiac Output During Spinal Anesthesia for Cesarean Section under Combined Prophylactic Noradrenaline Infusion"
Provisionally accepted
- Fujian Maternity and Child Health Hospital, Fuzhou, China
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Objective: Hypotension is a common complication of spinal anesthesia during cesarean section. Fluid loading strategies combined with vasopressor drug regimens can achieve this goal by maximizing cardiac output (CO) and minimizing the fall in systemic vascular resistance (SVR). This study aimed to use Vigileo techniques in order to compare the effects of different fluid loading strategies on CO fluctuation under a norepinephrine infusionMethods:We recruited 102 healthy term parturients scheduled for elective cesarean section under spinal anesthesia for this randomized double-blind study and divided them into two groups: the colloid preload followed by crystalloid coload group (500 ml each; Group 1, n=51), and the colloid and crystalloid coload group (500 ml each; Group 2, n=51). Our primary outcome was standardized maternal cardiac output (CO). The secondary outcome measures were stroke volume (SV), systolic blood pressure (SBP), heart rate (HR), number of episodes of hypotension, hypertension, bradycardia, nausea/vomiting and total norepinephrine dose. Neonatal outcome was assessed by recording Apgar scores 1 and 5 min after delivery and by measuring umbilical arterial (UA) blood gases. Results:Baseline .Before spinal anesthesia ，CO (6.84 ± 1.18 vs. 5.51 ± 0.96 L/min, P < 0.001)was significantly higher in group 1 than group 2，but this increase was not sustained after spinal anesthesia(P >0.05)。 SV (75.98 ± 13.01 vs. 66.37 ± 12.42 mL, P < 0.001) and SBP (124.84 ± 11.61 vs. 116.57 ± 7.57 mmHg, P < 0.001); followed a similar trend in the study. Only the largest percentage change in maternal HR (4.89 ± 11.89 vs. 10.38 ± 14.07, P = 0.036) was significantly different between the two groups. There were no significant differences between the two groups in terms of the maximum CO, SV, SBP, or HR after spinal anesthesia (P > 0.05).The maternal side effects and neonatal outcomes, were similar in two groups.(P >0.05)Conclusions: In combination with prophylactic norepinephrine infusion, 500-mL colloid preloading and 500-mL crystalloid coloading can significantly increase CO before spinal anesthesia for cesarean sections and provide improved hemodynamic stability after spinal anesthesia, with no difference in maternal or neonatal outcomes as compared to colloid and crystalloid coloading
Keywords: spinal anesthesia, Cesarean Section, Cardiac Output, noradrenaline, Hypotension
Received: 29 Jun 2024; Accepted: 12 May 2025.
Copyright: © 2025 Gao, Huang, lin, You, Liu, Hu, Zhang and Yan. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jianying Yan, Fujian Maternity and Child Health Hospital, Fuzhou, China
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