Dataset Information

Fluid loading therapy to prevent spinal hypotension in women undergoing elective caesarean section: Network meta-analysis, trial sequential analysis and meta-regression.

ABSTRACT:

Background

Fluid loading is one of the recognised measures to prevent hypotension due to spinal anaesthesia in women scheduled for a caesarean section.

Objective

We aimed to evaluate the current evidence on fluid loading in the prevention of spinal anaesthesia-induced hypotension.

Design

Systematic review and network meta-analysis with trial sequential analysis and meta-regression.

Data sources

Medline, Epub, Embase.com (Embase and Medline), Cochrane Central, Web of Science and Google Scholar were used.

Eligibility criteria

Only randomised controlled trials were used. Patients included women undergoing elective caesarean section who received either crystalloid or colloid fluid therapy as a preload or coload. The comparator was a combination of either a different fluid or time of infusion.

Results

A total of 49 studies (4317 patients) were included. Network meta-analysis concluded that colloid coload and preload offered the highest chance of success (97 and 67%, respectively). Conventional meta-analysis showed that crystalloid preload is associated with a significantly higher incidence of maternal hypotension than colloid preload: risk ratio 1.48 (95% CI 1.29 to 1.69, P?ConclusionUnlike previous meta-analysies, we found a lack of data obviating an evidence-based recommendation. In most studies, vasopressors were not given prophylactically as is recommended. Studies on the best fluid regimen in combination with prophylactic vasopressors are needed. Due to official european usage restrictions on the most studied colloid (HES), we recommend crystalloid coload as the most appropriate fluid regimen.

Trial registration

CRD42018099347.

SUBMITTER: Rijs K

PROVIDER: S-EPMC7752245 | biostudies-literature | 2020 Dec

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Fluid loading therapy to prevent spinal hypotension in women undergoing elective caesarean section: Network meta-analysis, trial sequential analysis and meta-regression.

Rijs Koen K Mercier Frédéric J FJ Lucas D Nuala DN Rossaint Rolf R Klimek Markus M Heesen Michael M

European journal of anaesthesiology 20201201 12

<h4>Background</h4>Fluid loading is one of the recognised measures to prevent hypotension due to spinal anaesthesia in women scheduled for a caesarean section.<h4>Objective</h4>We aimed to evaluate the current evidence on fluid loading in the prevention of spinal anaesthesia-induced hypotension.<h4>Design</h4>Systematic review and network meta-analysis with trial sequential analysis and meta-regression.<h4>Data sources</h4>Medline, Epub, Embase.com (Embase and Medline), Cochrane Central, Web of ...[more]

PMID: 33109924

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Dataset Information

Fluid loading therapy to prevent spinal hypotension in women undergoing elective caesarean section: Network meta-analysis, trial sequential analysis and meta-regression.

Background

Objective

Design

Data sources

Eligibility criteria

Results

Trial registration

Publications

Fluid loading therapy to prevent spinal hypotension in women undergoing elective caesarean section: Network meta-analysis, trial sequential analysis and meta-regression.

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