Pre ecclamsia c section

[dabears505]

What do you guys do in regards to volume for a pre ecclamtic going for a c section. Our scheduled non pre ecclamtics get at least a liter bolus prior to going to OR and getting a spinal. Pre ecclamtics don't get a huge bolus.

 

[patriot6]

I don’t think it matters / neo gtt post SAB

 

[woopedazz]

We co-load fluids for all patients as the SAB is being set up. No/maintainence fluids only prior to entering the theatre.

One in theatre; We run our PETs a bit dry. Less than 500mL total most of the time... Less if severe, more if indicated.

 

[pgg]

I don’t think it matters / neo gtt post SAB

Yeah, spinal in, patient down, turn on the phenylephrine infusion, chart, dream of not doing OB.

 

[jqueb29]

It doesn't matter much. If you don't want to give volume, phenylephrine will support their pressure fine. And if you do want to give volume, the whole "volume overload in preeclamptics" is pretty over-exaggerated with reasonable volume given.

 

[Blockit]

It doesn't matter much. If you don't want to give volume, phenylephrine will support their pressure fine. And if you do want to give volume, the whole "volume overload in preeclamptics" is pretty over-exaggerated with reasonable volume given.

Indeed. They may be puffy and hypertensive, but they tend to be intravascularly dry.

 

[drmwvr]

It would be a miracle if an actual liter went in before a spinal. The machinations the pre op nurses go through before an elective section really take my breath away...ie...their idea of a bolus is 999 on the alaris pump and from the time of the order to the actual OR time about 375 mls of IV fluid go in...take away...spinal, 80 mcg bolus, infusion...finish crystalloid bolus intraop....