Continuous Noninvasive Method for Estimating and Predicting Maternal and Fetal Hemodynamic Changes During Regional Anesthesia
| Status: | Active, not recruiting |
|---|---|
| Conditions: | Hospital, Women's Studies |
| Therapuetic Areas: | Other, Reproductive |
| Healthy: | No |
| Age Range: | 14 - 44 |
| Updated: | 4/21/2016 |
| Start Date: | September 2012 |
| End Date: | December 2016 |
A Continuous, Noninvasive Method for Estimating and Predicting Maternal and Fetal Hemodynamic Changes During Regional Anesthesia
Machine learning techniques and algorithms originally developed for use in the field of
robotics can be applied to continuous, noninvasive physiological waveform data to discover
hidden, hemodynamic relationships. Newly developed algorithms can, in real-time: 1) predict
cardiovascular collapse well ahead of any clinically significant changes in standard vital
signs, 2) monitor and estimate fluid resuscitation needs, 3) estimate acute blood loss
volume, and 4) estimate intracranial pressure. We hypothesize that these same methods can be
used to predict functional hypovolemia during regional anesthesia for labor or fetal
intervention.
robotics can be applied to continuous, noninvasive physiological waveform data to discover
hidden, hemodynamic relationships. Newly developed algorithms can, in real-time: 1) predict
cardiovascular collapse well ahead of any clinically significant changes in standard vital
signs, 2) monitor and estimate fluid resuscitation needs, 3) estimate acute blood loss
volume, and 4) estimate intracranial pressure. We hypothesize that these same methods can be
used to predict functional hypovolemia during regional anesthesia for labor or fetal
intervention.
Specific aims:
1. Collect noninvasive physiological waveform data from patients undergoing regional
anesthesia for labor or fetal intervention at the University of Colorado Hospital and
Children's Hospital Colorado.
2. Combine the physiological data from patient monitors with clinical and demographic
data, including maternal problem list, medications, volume infused, use of
vasopressors, arterial and venous pressures, fetal heart rate, fetal umbilical artery
Doppler velocimetry, maternal uterine artery Doppler waveform, fetal and neonatal
outcomes etc. for use in developing mathematical model for early detection of maternal
functional hypovolemia.
3. Develop robust, real-time, computational models for:
- estimating maternal volume status prior to administration of epidural anesthesia
- estimating effective intravascular volume loss during maternal regional anesthesia
- predicting an optimal, individual specific requirement for IV resuscitation and/or
need for vasopressor agents while providing adequate analgesia using regional
techniques and optimizing the fetal outcomes
- identifying mothers susceptible to epidural induced hypotension
1. Collect noninvasive physiological waveform data from patients undergoing regional
anesthesia for labor or fetal intervention at the University of Colorado Hospital and
Children's Hospital Colorado.
2. Combine the physiological data from patient monitors with clinical and demographic
data, including maternal problem list, medications, volume infused, use of
vasopressors, arterial and venous pressures, fetal heart rate, fetal umbilical artery
Doppler velocimetry, maternal uterine artery Doppler waveform, fetal and neonatal
outcomes etc. for use in developing mathematical model for early detection of maternal
functional hypovolemia.
3. Develop robust, real-time, computational models for:
- estimating maternal volume status prior to administration of epidural anesthesia
- estimating effective intravascular volume loss during maternal regional anesthesia
- predicting an optimal, individual specific requirement for IV resuscitation and/or
need for vasopressor agents while providing adequate analgesia using regional
techniques and optimizing the fetal outcomes
- identifying mothers susceptible to epidural induced hypotension
Inclusion Criteria:
- 1. Age: 14 - 44 years
- 2. Pregnant
- 3. Undergoing regional anesthesia for labor or fetal intervention at the University
of Colorado Hospital and Children's Hospital Colorado
Exclusion Criteria:
- 1. Severe pre-eclampsia/eclampsia
- 2. Pre-procedural maternal hypertension requiring treatment
- 3. Significant fetal heart rate abnormalities prior to regional anesthesia
- 4. Incarcerated
- 5. Decisionally challenged
- 6. Limited access to or compromised monitoring sites for non-invasive finger and ear
or forehead sensors
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