印度产科麻醉师协会-关于产妇心脏骤停管理的专家委员会共识声明和建议

S. Pandya, K. Jain, A. Grewal, Ketan Parikh, Karuna Sharma, Anjeleena Gupta, S. Kasodekar, A. Parameswari, D. Gogoi, L. Raiger, Gonibeed Rao Ravindra, Sunanda Gupta, A. Trikha
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引用次数: 1

摘要

产妇心脏骤停(MCA)需要一个精通复苏过程中涉及的级联步骤的多学科团队。从历史上看,产妇的结局很差,主要是因为孕妇的心脏骤停管理既不最佳也不标准化。然而,目前的证据表明,由于年龄小和死亡原因可逆,产妇存活率更高。有一些特殊的干预措施,如手动左子宫移位(MLUD)来缓解主动脉腔静脉压迫,如果不这样做,可能会破坏复苏的成功。该团队应同时探索MCA的病因,这可能是妊娠相关原因和合并症的结合。如果心肺复苏4-5分钟后仍未恢复自发循环,应考虑复苏子宫切开或复苏子宫干预术(RUI)。在MCA的高风险环境中,团队合作是成功的关键。这一共识声明是由专家在审查了MCA期间孕产妇复苏的循证文献后编写的。
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The association of obstetric anesthesiologists, India – An expert committee consensus statement and recommendations for the management of maternal cardiac arrest
Maternal cardiac arrest (MCA) requires a multidisciplinary team well versed in the cascade of steps involved during resuscitation. Historically, maternal outcomes were poor, primarily because cardiac arrest management in pregnant women was neither optimum nor standardized. However, current evidence has shown better maternal survival given the young age and reversible causes of death. There are specific interventions such as manual left uterine displacement (MLUD) for relief of aortocaval compression that, if not performed, may undermine the success of resuscitation. The team should simultaneously explore the etiology of MCA, which could be a combination of pregnancy-related causes and comorbid conditions. Resuscitative Hysterotomy or Resuscitative Uterine Interventions (RUI) should be considered if there is no return of spontaneous circulation following 4–5 min of cardiopulmonary resuscitation. Teamwork is critical to success in the high-stakes environment of MCA. This consensus statement was prepared by the experts after reviewing evidence-based literature on maternal resuscitation during MCA.
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审稿时长
29 weeks
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