• Paul Bonnin, Benjamin Constans, Alain Duhamel, Maéva Kyheng, Anne-Sophie Ducloy-Bouthors, Max Gonzalez Estevez, Benoit Tavernier, and Alexandre Gaudet.
• CHU Lille, Pôle d'Anesthésie-Réanimation, Lille, France.
• Can J Anaesth. 2022 Nov 1; 69 (11): 134013481340-1348.

PurposeIndividuals in late pregnancy are at risk of significant hemodynamic variations, especially during Cesarean delivery. Although non-invasive monitoring might enable the early detection of variations in cardiac output (CO), clinical validation is lacking.MethodsIn a prospective, single-center study, we measured CO simultaneously with finger plethysmography and transthoracic echocardiography in 100 third-trimester pregnant individuals in the supine and left lateral decubitus (LLD) positions.ResultsA Bland-Altman analysis revealed a mean (standard deviation) bias of 1.36 (1.04) L·min-1 in the supine position (95% limits of agreement, -0.68 to 3.4 L·min-1; percent error, 26.6%), indicating overestimation by finger plethysmography. The intra-class correlation coefficient was 0.43 (95% confidence interval [CI], 0.33 to 0.51). Regarding the changes in CO induced by the supine-to-LLD transition, the concordance rate in a four-quadrant plot was 98.3% (95% CI, 91.1 to 99.9%).ConclusionOur study showed a poor reliability of finger plethysmography for static measurement of CO. Nevertheless, finger plethysmography had a reasonably high concordance rate for the detection of CO changes secondary to positional changes in late-pregnant individuals. STUDY REGISTRATION DATE: www.Clinicaltrialsgov (NCT03735043); registered 8 November 2018.© 2022. Canadian Anesthesiologists' Society.

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