Key result
The subclavian vein collapsibility index effectively predicted hypotension during neuraxial anesthesia in patients with pregnancy-induced hypertension, yielding an area under the curve of 0.825.
Why the study?
To evaluate the predictive value of subclavian vein collapsibility index for hypotension during neuraxial anesthesia in patients with pregnancy-induced hypertension.
Does subclavian vein collapsibility index predict hypotension during neuraxial anesthesia in pregnant women with pregnancy-induced hypertension?
Observational (n=68)
No
Does subclavian vein collapsibility index predict hypotension during neuraxial anesthesia in pregnant women with pregnancy-induced hypertension?
Effect estimate: AUC 0.825 (95% CI 0.762-0.893)
p-value: p=<0.001
Subclavian vein collapsibility index measured before anesthesia has good predictive value for identifying pregnancy-induced hypertension patients at risk of hypotension during neuraxial anesthesia.
SCV-CI may predict hypotension in PIH cesarean patients; hypothesis-generating and requires prospective validation before practice change.
Objective: To explore and evaluate the predictive value of subclavian vein collapsibility index (SCV-CI) on hypotension during neuraxial anesthesia in patients with pregnancy-induced hypertension (PIH). Methods: Pregnant women with PIH who underwent elective cesarean section in our hospital from January to July 2021 were selected as the research subjects. Patients who experienced hypotension during anesthesia were included into the hypotension group, whereas patients who had a normal blood pressure during anesthesia were included in the normotensive group. The SCV-CI was then calculated for three respiratory cycles, the average value was taken as the base value, and the patient was monitored for another 20 minutes. The blood pressure, heart rate, blood oxygen saturation, and SCV-CI of the patients were measured, and the incidence of maternal nausea and vomiting and cord blood gas were recorded. Then, a correlation analysis was conducted on the relationship between subclavian vein collapsibility index and hypotension. A receiver operating characteristic curve was drawn to seek the threshold value of subclavian vein collapsibility index for post-anesthesia hypotension. Results: There was no significant difference in systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) between the two groups before anesthesia (P > 0.05). After anesthesia, the above indexes (SBP, 103.25 ± 12.48 mmHg; DBP, 58.94 ± 7.46 mmHg; and HR, 52.96 ± 6.48 beats/min) were significantly lower than those of the normal blood pressure group, and the difference was statistically significant (P < 0.05). In comparison, the SCV-CI in the hypotension group was 35.82 ± 4.93% greater than that in the normal blood pressure group (23.85 ± 5.27%), and the incidence of nausea and vomiting in the hypotension group (40.0%) was significantly higher than that in the normotensive group (10.53%), and the difference was statistically significant (P < 0.05). The area under the curve of SCV-CI prediction against hypotension in patients with PIH under neuraxial anesthesia was 0.825 (95% CI: 0.762–0.893, P < 0.001), the cut-off value was 25.68%, the predictive sensitivity was 92.68%, and the specificity was 81.24%. Conclusion: SCV-CI has a good predictive value for the occurrence of hypotension in patients with PIH during neuraxial anesthesia.
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Zhao et al. (2023) conducted an observational in Pregnancy-induced hypertension (n=68). Subclavian vein collapsibility index was evaluated on Prediction of hypotension during neuraxial anesthesia (AUC 0.825, 95% CI 0.762-0.893, p=<0.001). The subclavian vein collapsibility index effectively predicted hypotension during neuraxial anesthesia in patients with pregnancy-induced hypertension, yielding an area under the curve of 0.825.
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