Falla respiratoria y embarazo / Respiratory failure in pregnancy.

Octubre 6, 2017. No. 2833

Falla respiratoria aguda en el embarazo Acute respiratory failure in pregnancy. Lapinsky SE1. Author information Obstet Med. 2015 Sep;8(3):126-32. doi: 10.1177/1753495X15589223. Epub 2015 Jun 10. Abstract Respiratory failure affects up to 0.2% of pregnancies, more commonly in the postpartum period. Altered maternal respiratory physiology affects the assessment and management of these patients. Respiratory failure may result from pregnancy-specific conditions such as preeclampsia, amniotic fluid embolism or peripartum cardiomyopathy. Pregnancy may increase the risk or severity of other conditions, including thromboembolism, asthma, viral pneumonitis, and gastric acid aspiration. Management during pregnancy is similar to the nonpregnant patient. Endotracheal intubation in pregnancy carries an increased risk, due to airway edema and rapid oxygen desaturation following apnea. Few data are available to direct prolonged mechanical ventilation in pregnancy. Chest wall compliance is reduced, perhaps permitting slightly higher airway pressures. Optimizing oxygenation is important, but data on the use of permissive hypercapnia are limited. Delivery of the fetus does not always improve maternal respiratory function, but should be considered if benefit to the fetus is anticipated. PDF Evolución materna y neonatal de la falla respiratoria durante el embarazo Maternal and neonatal outcomes of respiratory failure during pregnancy. Hung CY1, Hu HC1, Chiu LC1, Chang CH1, Li LF1, Huang CC1, Kao CC2, Cheng PJ2, Kao KC3. Author information J Formos Med Assoc. 2017 May 17. pii: S0929-6646(17)30143-2. doi: 10.1016/j.jfma.2017.04.023. [Epub ahead of print] Abstract BACKGROUND: Obstetric patients comprise a limited portion of intensive care unit patients, but they often present with unfamiliar conditions and exhibit the potential for catastrophic deterioration. This study evaluated the maternal and neonatal outcomes of respiratory failure during pregnancy. METHODS: Information on 71 patients at >25 weeks gestation in the ICU with respiratory failure was recorded between 2009 and 2013. The characteristics and outcomes of mothers and fetuses were determined through a retrospective chart review and evaluated using Student's t test, chi-square test, and Fisher's exact test. RESULTS: The leading causes of respiratory failure were postpartum hemorrhage and severe preeclampsia in the obstetric causes group and pneumonia in the nonobstetric causes group during pregnancy and the peripartum period. The non-obstetric causes group exhibited a higher incidence of acute respiratory distress syndrome and renal replacement therapy as well as requiring more ventilator days. The patients in the obstetric causes group showed significant improvement after delivery in the partial pressure of arterial oxygen to the fraction of inspired oxygen and peak inspiratory pressure decrease. Both groups exhibited high incidences of neonatal respiratory distress syndrome. Neonatal complications resulting from meconium aspiration syndrome (MAS) and sepsis were more common in the non-obstetric causes group; however, neurological development impairment was more common in the obstetric causes group. CONCLUSION: Obstetric cause was associated with longer ventilator free days and fewer episodes of ARDS after delivery. Neonatal complications resulting from different etiologies of respiratory failure were found to differ. KEYWORDS: Acute respiratory distress syndrome; Neonatal; Obstetric; Outcome; Respiratory failure PDF PATOLOGIA RESPIRATORIA CRÍTICA DURANTE EL EMBARAZO. Medicina Intensiva Dr. Carlos Lovesio PDF XIV Congreso Virtual Mexicano de Anestesiología 2017 Octubre 1-Diciembre 31, 2017 Información / Information Video informativo XXVII Congreso Peruano de Anestesiología Lima, Noviembre 2-4, 2017 Informes / Information

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