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. 2011 Apr;9(2):189–217. doi: 10.2450/2011.0075-10

Table I.

Clinical and instrumental parameters indicative of hypoxia in the anaemic, normovolaemic patient27§.

Cardiopulmonary symptoms

  • - Tachycardia*

  • - Hypotension**

  • - Acute hypotension of unknown origin

  • - Dyspnoea


Electrocardiographic signs typical of ischaemia

  • - Newly occurring ST segment elevation or depression

  • - Onset of arrhythmias

  • - Newly occurring localised altered contractility of the myocardium


Global indices of insufficient O2 release, evaluated by invasive methods

  • - Increase in overall O2 extraction greater than 50%

  • - Reduction of O2 uptake by more than 10% of the initial value

  • - Reduction of mixed venous O2 saturation to below 50%

  • - Reduction of peripheral mixed venous pO2 to below 32 mmHg

  • - Reduction of central venous O2 saturation to below 60%

  • - Lactate acidosis (lactates >2 mmol/L + acidosis)

Notes

§:

At term, pregnant women have about a 45% increase (about 1.5 L) in blood volume, with a greater increase in plasma than in red blood cells, leading to the so-called haemodilution anaemia of pregnancy which reduces the Htc by about 10%6.

*:

Tachycardia may already be present at baseline in pregnant women or develop as the result of an infusion of a tocolytic6.

**:

Placental perfusion in patients with hypertensive disorders during pregnancy, such as pre-eclampsia or haemolytic anaemia with elevated liver enzymes and low platelet count (HELLP) syndrome, can be inadequate at blood pressure values tolerated by other patients because of the increased peripheral resistance6.