Acute Respiratory Distress Syndrome in Pregnancy.

Autor: Pandya ST; Department of Anaesthesia, Peri-operative Medicine and Critical Care, AIG Hospitals, Hyderabad, Telangana, India., Krishna SJ; Department of Anaesthesia, Peri-operative Medicine and Critical Care, AIG Hospitals, Hyderabad, Telangana, India.
Jazyk: angličtina
Zdroj: Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine [Indian J Crit Care Med] 2021 Dec; Vol. 25 (Suppl 3), pp. S241-S247.
DOI: 10.5005/jp-journals-10071-24036
Abstrakt: Acute respiratory distress syndrome (ARDS) is a clinical syndrome characterized by several clinical features and pathological responses involving the respiratory system primarily. Infections (viral), sepsis, and massive transfusion are the commonest causes of ARDS during pregnancy. The majority of them recover with noninvasive ventilatory (NIV) support. NIV is safe in pregnancy provided the center is experienced and has a protocolized patient care pathway. Parturients requiring invasive mechanical ventilation are best managed in experienced centers. PaO 2 /FiO 2 targets are higher in parturients compared to nonpregnant patients. Permissive hypercapnia is not a safe option in pregnancy. In severe ARDS with refractory hypoxemia, prone ventilation is a safe option. However, it has to be done in experienced centers. Venovenous ECMO is a safe alternative option in pregnant women with refractory hypoxemia, and delivery has been prolonged to a safe viable age on ECMO. The decision to deliver and the mode of delivery have to be a multidisciplinary decision; primary criterion is maternal survival. Postdelivery, establishing maternal bonding while in ventilatory support facilitates early weaning and minimizes lactation failure.
How to Cite This Article: Pandya ST, Krishna SJ. Acute Respiratory Distress Syndrome in Pregnancy. Indian J Crit Care Med 2021; 25(Suppl 3):S241-S247.
Competing Interests: Source of support: Nil Conflict of interest: None
(Copyright © 2021; Jaypee Brothers Medical Publishers (P) Ltd.)
Databáze: MEDLINE
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