Trial reportBMC anesthesiology2026
Transthoracic echocardiographic evaluation of maternal cardiac output: colloid preload versus crystalloid coload during cesarean delivery under spinal anesthesia: randomized clinical trial.
Trial report in BMC anesthesiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06654687 (Transthoracic Echocardiographic Monitoring of Cardiac Output Effects of Colloid Preload and Crystalloid Coload During Cesarean Delivery Under Spinal Anesthesia), which is not on this map. Not yet cited in PubMed.
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Transthoracic Echocardiographic Monitoring of Cardiac Output Effects of Colloid Preload and Crystalloid Coload During Cesarean Delivery Under Spinal Anesthesia
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6 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundSpinal anesthesia-induced hypotension during cesarean delivery primarily results from vasodilation. While phenylephrine restores blood pressure, it may reduce maternal cardiac output (CO) by up to 20%. Limited data exists on the cardiac effects of different fluid strategies as measured by transthoracic echocardiography (TTE), particularly when using albumin as a colloid component. This study compared the CO effects of albumin preload combined with crystalloid coload versus crystalloid coload alone.
methodsIn this randomized, double-blind study, 162 ASA II parturients scheduled for elective cesarean delivery were assigned to crystalloid coload (1000 mL Ringer’s lactate; n = 81) or combination therapy (250 mL albumin 5% preload plus 750 mL Ringer’s lactate coload; n = 81). Both groups received prophylactic phenylephrine infusion. The primary outcome was the group-by-time interaction in CO measured by TTE at baseline, 1 and 5 min post-spinal anesthesia, post-delivery, and 1-hour post-study.
resultsThe CO group-by-time interaction was not statistically significant (p = 0.067). In an exploratory post-hoc analysis, the overall group effect across all time points favored the combination group by 0.33 L/min (95% CI: 0.02–0.64; p = 0.038). The combination group demonstrated significantly higher velocity time integral (VTI; mean difference 1.32 cm, 95% CI: 0.87–1.77; p < 0.0001). Vasopressor requirements, APGAR scores, and adverse events were comparable between groups. Urine output was higher in the combination group (p = 0.038).
conclusionsNo significant difference in temporal CO patterns was found between fluid strategies (group-by-time interaction p = 0.067). Despite improved VTI with combination therapy (exploratory finding), vasopressor consumption and maternal-neonatal outcomes showed no clinically meaningful differences. CLINICAL
trial registrationNCT06654687 (ClinicalTrials.gov, registered October 22, 2024.
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