CORRESPONDENCE| Volume 20, ISSUE 4, P359-360, October 2011

Download started.


In reply

Published:September 12, 2011DOI:
      We thank Drs. Beavan and Clift for their comments. They suggest that passive-leg-rising (PLR) be used to evaluate fluid responsiveness in a spontaneous breathing patient as stroke volume variation (SVV) has only been fully validated in mechanically-ventilated patients. In the case described there were various problems: the patient refused blood transfusion and the issue was to balance fluid administration, oxygen delivery and consumption and hemodilution. As a result, in addition to SVV, we used cardiac index, stroke volume and the calculated oxygen delivery to guide our interventions. We looked at trends of these values rather than isolated numbers and believe this to be a useful approach.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to International Journal of Obstetric Anesthesia
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Auler Jr, J.O.
        • Torres M.L.
        • Cardoso M.M.
        • et al.
        Clinical evaluation of the Flotrac/Vigileo system for continuous cardiac output monitoring in patients undergoing regional anesthesia for elective cesarean section: a pilot study.
        Clinics (Sao Paulo). 2010; 65: 793-798
        • Dyer R.A.
        • James M.F.
        Maternal hemodynamic monitoring in obstetric anesthesia.
        Anesthesiology. 2008; 109: 765-767
        • Raghunathan K.
        • Zuegge K.L.
        • Connelly N.R.
        • Lucas T.
        Maternal hemodynamic monitoring and the Vigileo monitor.
        Anesthesiology. 2009; 111: 211-212