Challenges during cardiac arrest in pregnancy DOI Creative Commons

Korneel Berteloot,

Marc Sabbé

Resuscitation Plus, Journal Year: 2024, Volume and Issue: 21, P. 100855 - 100855

Published: Dec. 28, 2024

A 36-year-old woman at 23 weeks and 3 days of gestation experienced a witnessed cardiopulmonary collapse. Bystander resuscitation (CPR) was initiated immediately. After advanced life support, she transferred under mechanical CPR to hospital for extracorporeal membrane oxygenation (ECMO). There, delayed perimortem caesarean section (PMCS) performed. Consideration initiate ECMO following the PMCS ultimately discontinued due extensive intra-abdominal haemorrhage elapsed time over one hour since full body computed tomography (CT) scan ROSC revealed bilateral pulmonary embolisms grade 4 liver laceration with active bleeding CPR. Despite prolonged duration cardiac arrest (69 min) significant metabolic derangements, patient had favourable recovery discharged after 42 good neurological outcome. This case illustrates challenges timely in out-of-hospital arrest, where guidelines recommend performing procedure within min maternal It also highlights risks associated chest compression devices.

Language: Английский

Critical Care Pharmacology of Antiretroviral Therapy in Adults DOI Creative Commons
Luigi La Via, Andrea Marıno, Giuseppe Cuttone

et al.

European Journal of Drug Metabolism and Pharmacokinetics, Journal Year: 2025, Volume and Issue: 50(2), P. 105 - 118

Published: Feb. 12, 2025

The clinical pharmacology of antiretroviral therapy (ART) in critical care presents unique challenges due to the complex interplay between HIV infection, illness, and drug management. This comprehensive review examines pharmacokinetic pharmacodynamic considerations drugs critically ill patients, where altered absorption, distribution, metabolism, excretion significantly impact effectiveness safety. Critical illness can substantially modify pharmacokinetics through various mechanisms, including impaired gastrointestinal motility, fluid shifts, hypoalbuminemia, hepatic dysfunction, renal function. These changes, combined with potential drug-drug interactions polypharmacy environment intensive units, necessitate careful consideration dosing strategies monitoring approaches. addresses specific scenarios, management ART patients organ during replacement therapy, special populations such as those sepsis or acute respiratory distress syndrome. It also explores role therapeutic optimizing managing toxicities settings. Emerging areas research, long-acting formulations, nanotechnology-based delivery systems, personalized medicine approaches, are discussed future directions for improving care. emphasizes importance a multidisciplinary approach involving physicians, infectious disease specialists, pharmacists optimize outcomes this patient population. provides clinicians practical guidance while highlighting requiring further research enhance our understanding improve challenging setting.

Language: Английский

Citations

0
Venoarterial extracorporeal membrane oxygenation is a feasible option for patients with pregnancy-associated diagnoses who require mechanical circulatory support DOI Creative Commons

Trishna B Parikh,

Sabiha Armin,

Saad Khan

et al.

Resuscitation Plus, Journal Year: 2025, Volume and Issue: unknown, P. 100983 - 100983

Published: May 1, 2025

Language: Английский

Citations

0
Incidence, Risk Factors and Outcomes of SARS‐CoV‐2 Infection in Pregnant Women: The COROPREG Population‐Based Study DOI Creative Commons
Caroline Diguisto, Pierre‐Yves Ancel, Aurélien Seco

et al.

Paediatric and Perinatal Epidemiology, Journal Year: 2025, Volume and Issue: unknown

Published: May 21, 2025

ABSTRACT Background Population‐based data are needed to reliably assess the impact of SARS‐CoV‐2 infection during pregnancy. Objectives To estimate population‐based incidence and its severe forms in obstetric population, identify risk factors (severe COVID‐19) describe delivery, maternal neonatal outcomes by disease severity, using a definition severity based on organ dysfunction. Methods A prospective study conducted over three first pandemic waves between March 2020 April 2021 281 maternity hospitals six French regions included all women with pregnancy or within 7 days post‐partum, whether symptomatic not, hospitalised not. Severe COVID‐19 were defined priori clinical, biological management criteria We calculated rates studied associations sociodemographic, medical characteristics univariate multivariate modified Poisson regression modelling. Results From population 385,214 deliveries participating regions, 6015 identified, including 337 cases. The 1.1, 0.9 3.6 per 1000 first, second third waves, respectively, proportions 8.6%, 3.4% 9.3%, respectively. On analysis, was associated younger older age, migrant status, living > 4 people, overweight obesity, chronic hypertension diabetes ≥ 22 weeks gestation rather than earlier Neonatal morbidity occurred mostly infection. Conclusion Using an organ‐based data, appeared lower previous studies. permanent perinatal surveillance system is efficiently rapidly future pandemics.

Language: Английский

Citations

0
Challenges during cardiac arrest in pregnancy DOI Creative Commons

Korneel Berteloot,

Marc Sabbé

Resuscitation Plus, Journal Year: 2024, Volume and Issue: 21, P. 100855 - 100855

Published: Dec. 28, 2024

A 36-year-old woman at 23 weeks and 3 days of gestation experienced a witnessed cardiopulmonary collapse. Bystander resuscitation (CPR) was initiated immediately. After advanced life support, she transferred under mechanical CPR to hospital for extracorporeal membrane oxygenation (ECMO). There, delayed perimortem caesarean section (PMCS) performed. Consideration initiate ECMO following the PMCS ultimately discontinued due extensive intra-abdominal haemorrhage elapsed time over one hour since full body computed tomography (CT) scan ROSC revealed bilateral pulmonary embolisms grade 4 liver laceration with active bleeding CPR. Despite prolonged duration cardiac arrest (69 min) significant metabolic derangements, patient had favourable recovery discharged after 42 good neurological outcome. This case illustrates challenges timely in out-of-hospital arrest, where guidelines recommend performing procedure within min maternal It also highlights risks associated chest compression devices.

Language: Английский

Citations

0