Version May 2024
| Hemodynamic goals | Avoid | Monitor | Intervention |
| Sinus rhythm | Electromagnetic interference due to electrocautery in patients with an ICD | 5-lead ECG | Management of an ICD:
|
| Normal heart rate | Bradycardia | 5-lead ECG Pulse oximetry with visible waveform | Treat bradycardia with ephedrine; gycopyrrolate if necessary. |
| Maintain contractility | Myocardial depression | Hemoynamics | Treat low cardiac output syndrome with milrinone or dobutamine; epinephrine or norepinephrine may be added if necessary to treat hypotension. |
| Maintain afterload | Hypertension | Intra-arterial blood pressure | Prevent pain-induced hypertension by minimizing or eliminating labor pain with effective analgesia. |
| Hypotension | Intra-arterial blood pressure | Treat hypotension with ephedrine or norepinephrine. | |
| Adequate preload | Hypervolemia | Clinical course and oxygenation. Development of pulmonary edema (may present as acute coughing and hypoxemia in the awake patient). | Management of pulmonary edema:
|
| Hypovolemia | Hemodynamics | Allow oral intake and administer maintenance IV fluids, if necessary, to maintain adequate preload. | |
| Minimize pulmonary vascular resistance (optimize oxygenation and ventilation) | Hypoxemia or hypercarbia | Pulse oximetry with visible waveform | Minimize risk of hypoxemia and hypercarbia by:
|
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