scholarly journals Anesthetic Management of Patient with Preeclampsia, Pulmonary Edema, and Peripartum Cardiomyopathy in Pregnancy Undergoing Caesarean Section: A Case Report

2021 ◽  
Vol 4 (3) ◽  
Author(s):  
Doddy Tavianto ◽  
◽  
Reza W Sudjud ◽  
Putri C Barliana ◽  
Indra Wijaya
Keyword(s):  
Pulmonary Edema ◽  
Myocardial Dysfunction ◽  
Anesthetic Management ◽  
Fetal Distress ◽  
Positive Pressure ◽  
Depressant Effect ◽  
Intubation Technique ◽  
Organ Systems ◽  
Disease Case ◽  
In Pregnancy

Preeclampsia is a disease that occurs in pregnancy after 20 weeks of gestation with manifestations involving multi organ systems such as pulmonary edema and ventricle dysfunction. Cardiomyopathy is a heart disorder characterized by myocardial dysfunction unrelated to any other previous heart disease. Case: A 31-year-old woman diagnosed with G1P0A0 full-term pregnancy, preeclampsia, pulmonary edema, cardiomyopathy, and fetal distress, who underwent cesarean section. On physical examination, shortness of breath was found in semi-Fowler position. Patient had high blood pressure and global hypokinesis was found on echocardiography results. She was planned for general anesthesia with semi-closed intubation technique and breath controlled. Anesthetic management should optimize the preoxygenation, provide positive pressure ventilation with positive end-expiratory pressure (PEEP), maintain the minimal myocardial depressant effect of drugs, and maintain a normovolemic state. It could improve the good outcomes. Conclusion: Three things that must be considered when starting the induction are oxygenation, fluid status, and selection of drugs that do not make the heart work harder. The combination of fentanyl, midazolam, and sevoflurane is the drug of choice used for induction, because it can minimize the cardiac depressant effect.

scholarly journals Anesthetic Management of Patient with Preeclampsia, Pulmonary Edema, and Peripartum Cardiomyopathy in Pregnancy Undergoing Caesarean Section: A Case Report

2021 ◽  
Author(s):  
Doddy Tavianto ◽  
Reza W Sudjud ◽  
Putri C Barliana ◽  
Indra Wijaya
Keyword(s):  
Pulmonary Edema ◽  
Myocardial Dysfunction ◽  
Anesthetic Management ◽  
Fetal Distress ◽  
Positive Pressure ◽  
Depressant Effect ◽  
Intubation Technique ◽  
Organ Systems ◽  
Disease Case ◽  
In Pregnancy

Preeclampsia is a disease that occurs in pregnancy after 20 weeks of gestation with manifestations involving multi organ systems such as pulmonary edema and ventricle dysfunction. Cardiomyopathy is a heart disorder characterized by myocardial dysfunction unrelated to any other previous heart disease. Case: A 31-year-old woman diagnosed with G1P0A0 full-term pregnancy, preeclampsia, pulmonary edema, cardiomyopathy, and fetal distress, who underwent cesarean section. On physical examination, shortness of breath was found in semi-Fowler position. Patient had high blood pressure and global hypokinesis was found on echocardiography results. She was planned for general anesthesia with semi-closed intubation technique and breath controlled. Anesthetic management should optimize the preoxygenation, provide positive pressure ventilation with positive end-expiratory pressure (PEEP), maintain the minimal myocardial depressant effect of drugs, and maintain a normovolemic state. It could improve the good outcomes. Conclusion: Three things that must be considered when starting the induction are oxygenation, fluid status, and selection of drugs that do not make the heart work harder. The combination of fentanyl, midazolam, and sevoflurane is the drug of choice used for induction, because it can minimize the cardiac depressant effect.

Reversible Myocardial Dysfunction and Clinical Outcome in Scuba Divers With Immersion Pulmonary Edema

2013 ◽  
Vol 111 (11) ◽  
pp. 1655-1659 ◽  
Author(s):  
Emmanuel Gempp ◽  
Pierre Louge ◽  
Anne Henckes ◽  
Sebastien Demaistre ◽  
Phillipe Heno ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Pulmonary Edema ◽  
Myocardial Dysfunction ◽  
Scuba Divers

Acute pulmonary edema in pregnancy

1953 ◽  
Vol 65 (2) ◽  
pp. 314-319 ◽  
Author(s):  
Morton A. Goldmann ◽  
Nicholas P. Primiano
Keyword(s):  
Pulmonary Edema ◽  
Acute Pulmonary Edema ◽  
In Pregnancy

Combination of constant-flow and continuous positive-pressure ventilation in canine pulmonary edema

1989 ◽  
Vol 67 (2) ◽  
pp. 817-823 ◽  
Author(s):  
J. I. Sznajder ◽  
C. J. Becker ◽  
G. P. Crawford ◽  
L. D. Wood
Keyword(s):  
Pulmonary Edema ◽  
Positive Pressure Ventilation ◽  
Alveolar Ventilation ◽  
Positive Pressure ◽  
Constant Flow ◽  
Positive End Expiratory Pressure ◽  
Ventilatory Mode ◽  
Continuous Positive Pressure ◽  
Bronchoscopic Guidance ◽  
Normal Lungs

Constant-flow ventilation (CFV) maintains alveolar ventilation without tidal excursion in dogs with normal lungs, but this ventilatory mode requires high CFV and bronchoscopic guidance for effective subcarinal placement of two inflow catheters. We designed a circuit that combines CFV with continuous positive-pressure ventilation (CPPV; CFV-CPPV), which negates the need for bronchoscopic positioning of CFV cannula, and tested this system in seven dogs having oleic acid-induced pulmonary edema. Addition of positive end-expiratory pressure (PEEP, 10 cmH2O) reduced venous admixture from 44 +/- 17 to 10.4 +/- 5.4% and kept arterial CO2 tension (PaCO2) normal. With the innovative CFV-CPPV circuit at the same PEEP and respiratory rate (RR), we were able to reduce tidal volume (VT) from 437 +/- 28 to 184 +/- 18 ml (P less than 0.001) and elastic end-inspiratory pressures (PEI) from 25.6 +/- 4.6 to 17.7 +/- 2.8 cmH2O (P less than 0.001) without adverse effects on cardiac output or pulmonary exchange of O2 or CO2; indeed, PaCO2 remained at 35 +/- 4 Torr even though CFV was delivered above the carina and at lower (1.6 l.kg-1.min-1) flows than usually required to maintain eucapnia during CFV alone. At the same PEEP and RR, reduction of VT in the CPPV mode without CFV resulted in CO2 retention (PaCO2 59 +/- 8 Torr). We conclude that CFV-CPPV allows CFV to effectively mix alveolar and dead spaces by a small bulk flow bypassing the zone of increased resistance to gas mixing, thereby allowing reduction of the CFV rate, VT, and PEI for adequate gas exchange.

scholarly journals Endocannabinoid System in Pregnancy Maintenance and Labor: A Mini-Review

2021 ◽  
Vol 12 ◽  
Author(s):  
Melissa L. Kozakiewicz ◽  
Chad A. Grotegut ◽  
Allyn C. Howlett
Keyword(s):  
Early Pregnancy ◽  
Endocannabinoid System ◽  
Current Theory ◽  
Multiple Organ ◽  
Late Gestation ◽  
Signaling System ◽  
Organ Systems ◽  
A Cell ◽  
Term Labor ◽  
In Pregnancy

The endocannabinoid system (ECS) is a cell-signaling system present in multiple organ systems and is an integral part of sustaining the microenvironment necessary for early pregnancy success and maintenance. It plays a significant role in embryo development, transport and implantation as well as placentation. The current theory behind the initiation of term labor is that it is a complex, multifactorial process involving sex steroid hormones, prostaglandin production and interplay at the maternal-fetal interface resulting in increased expression of receptors and gap junctions that promote uterine activation. There is increasing evidence that, in addition to early pregnancy events, the ECS plays a regulatory role in pregnancy maintenance and the timing of labor. This review presents an overview of the ECS in pregnancy that focuses on late gestation and parturition.

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