Measurements of Cardiac Stroke Volume in Various Body Positions in Pregnancy and during Caesarean Section: A Comparison Between Thermodilution and Impedance Cardiography

Abstract

A total of 220 simultaneous pairs of measurements of cardiac stroke volume were made in twelve women before and during Caesarean section in order to compare impedance cardiography with the thermodilution method. A significantly higher coefficient of correlation was found before (r = 0.77) than during anaesthesia (r = 0.55). Further, there was a significant difference in the slope of the regression lines: before anaesthesia the slope was 1.07 and during anaesthesia with thiopentone, nitrous oxide, oxygen and suxamethonium it was 0.45. Significant changes in the intercept on the F-axis were found before (-13.9 ml) and during anaesthesia (33.4 ml). When the uterus was displaced upwards and to the left from the 15d` tilt position the stroke volume and the cardiac output were increased when measured by both methods to nearly the same values as in the left lateral position. It is concluded that the impedance method is reliable for measuring cardiac stroke volume in late pregnancy under physiological conditions in the conscious patient, but that it cannot replace the thermodilution method in pharmacological studies.

Key Words:

• anaesthesia
• body tilt
• caesarean section
• cardiac output
• impedance cardiograph
• pregnancy
• thermodilution technique
• vena cava inferior syndrome