Amniotic Fluid Embolism Treated With Inhaled Milrinone: A Case Report.

Autor: Baxter FJ; From the Department of Anesthesia, McMaster University, Hamilton, Ontario., Whippey A
Jazyk: angličtina
Zdroj: A&A practice [A A Pract] 2020 Nov; Vol. 14 (13), pp. e01342.
DOI: 10.1213/XAA.0000000000001342
Abstrakt: We present a patient with sudden cardiovascular collapse during cesarean delivery that was attributed to amniotic fluid embolism (AFE). The syndrome of AFE may be initiated by an anaphylactoid response to amniotic fluid in the maternal circulation that triggers the release of pulmonary vasoconstrictors, with transient pulmonary vasospasm, causing hemodynamic collapse and profound left ventricular failure. Milrinone, a pulmonary vasodilator used in the management of emergent right ventricular failure, was administered via a nebulizer in an effort to decrease pulmonary vascular resistance. If used immediately after AFE, inhaled milrinone may mitigate pulmonary vasoconstriction, providing a bridge to extracorporeal membrane oxygenation.
Databáze: MEDLINE