Part 12: Cardiac Arrest in Special Situations

Hoek, Terry L. Vanden; Morrison, Laurie J.; Shüster, Michael; Donnino, Michael W.; Sinz, Elizabeth H.; Lavonas, Eric J.; Jeejeebhoy, Farida M.; Gabrielli, A.

doi:10.1161/circulationaha.110.971069

Cited by 660 publications

(506 citation statements)

References 502 publications

(388 reference statements)

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“…In pregnancy it has been suggested that epinephrine may inhibit utero‐placental blood flow 28. However, fetal survival is maximised through maternal resuscitation 29. Findings from the Confidential Enquiry into Maternal Death in the UK recommended that epinephrine should be the first line treatment for anaphylaxis in pregnancy 22, 30.…”

Section: Discussionmentioning

confidence: 99%

The incidence, characteristics, management and outcomes of anaphylaxis in pregnancy: a population‐based descriptive study

McCall

Bunch

Brocklehurst

et al. 2018

BJOG

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ObjectiveThe aim of this study was to estimate the incidence of anaphylaxis in pregnancy and describe the management and outcomes in the UK.DesignA population‐based descriptive study using the UK Obstetric Surveillance System (UKOSS).SettingAll consultant‐led maternity units in the UK.PopulationAll pregnant women who had anaphylaxis between 1 October 2012 and 30 September 2015. Anaphylaxis was defined as a severe, life‐threatening generalised or systemic hypersensitivity reaction.MethodsProspective case notification using UKOSS.Main outcome measuresMaternal mortality, severe maternal morbidity, neonatal mortality and severe neonatal morbidity.ResultsThere were 37 confirmed cases of anaphylaxis in pregnancy, giving an estimated incidence of 1.6 (95% CI: 1.1–2.2) per 100 000 maternities. Four cases of anaphylaxis were in women with known penicillin allergies: two received co‐amoxiclav and two cephalosporins. Twelve women had anaphylaxis following prophylactic use of antibiotics at the time of a caesarean delivery. Prophylactic use of antibiotics for Group B streptococcal infection accounted for anaphylaxis in one woman. Two women died (5%), 14 (38%) women were admitted to intensive care and seven women (19%) had one or more additional severe maternal morbidities, which included three haemorrhagic events, two cardiac arrests, one thrombotic event and one pneumonia. No infants died; however, in those infants whose mother had anaphylaxis before delivery (n = 18) there were seven (41%) neonatal intensive care unit admissions, three preterm births and one baby was cooled for neonatal encephalopathy.ConclusionsAnaphylaxis is a rare severe complication of pregnancy and frequently the result of a reaction to antibiotic administration. This study highlights the seriousness of the outcomes of this condition for the mother. The low incidence is reassuring given the large proportion of the pregnant population that receive prophylactic antibiotics during delivery.Tweetable abstractAnaphylaxis is a rare severe complication of pregnancy and frequently the result of a reaction to antibiotic administration.

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Section: Discussionmentioning

confidence: 99%

The incidence, characteristics, management and outcomes of anaphylaxis in pregnancy: a population‐based descriptive study

McCall

Bunch

Brocklehurst

et al. 2018

BJOG

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“…The American Heart Association, the European Resuscitation Council, and the Royal College of Obstetricians and Gynaecologists have published evidence‐based guidelines for perinatal resuscitation 1, 7, 8. It is necessary to modify common resuscitation guidelines for the perinatal context because of maternal physical and anatomical changes.…”

Section: Discussionmentioning

confidence: 99%

“…It is necessary to modify common resuscitation guidelines for the perinatal context because of maternal physical and anatomical changes. The guidelines of both the International Consensus Conference on Cardiopulmonary Resuscitation and the Emergency Cardiovascular Care Science with Treatment Recommendations have recommended that when normal CPR is not successful in cases of CPA in women more than 20 weeks pregnant, the PMCD decision should be made within 4 min from CPA, and the baby removed within 5 min 1, 7, 8. This principle has also been reflected since 2014 in Japanese practice guidelines.…”

Section: Discussionmentioning

confidence: 99%

“…American Heart Association guidelines for cardiopulmonary arrest (CPA) suggest that perimortem cesarean delivery (PMCD) is the only way to resuscitate pregnant woman in cardiac arrest 1. Perimortem cesarean delivery has been found to increase the maternal resuscitation rate by effecting expulsion of the baby, increasing the circulating plasma volume 2, 3.…”

Section: Introductionmentioning

confidence: 99%

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Perimortem cesarean delivery and subsequent emergency hysterectomy: new strategy for maternal cardiac arrest

Goto¹,

Watanabe

Ogita³

et al. 2017

Acute Medicine & Surgery

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CasesPerimortem cesarean delivery (PMCD) is the only way to resuscitate pregnant women in cardiac arrest, and has been found to increase maternal resuscitation rate by increasing circulating plasma volume. However, many obstetricians have not experienced a case of PMCD, as situations requiring it are rare. We report our strategy for cases of maternal cardiac arrest, on the basis of a review of published work, and present two case reports from our medical center.OutcomesIn case 1, PMCD led to death by massive bleeding. In case 2, PMCD and hysterectomy were carried out after the introduction of venoarterial extracorporeal membrane oxygenation, and both mother and baby survived.ConclusionWe find that rapid hysterectomy as a damage control surgery following PMCD can be life‐saving for both mother and baby.

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“…Gegen extrapyramidalmotorische Symptome ist Diphenhydramin in einer intravenösen Dosis von 25-50 mg wirksam. Amantadin, Benzodiazepine oder Propranolol stellen Alternativen dar [10]. Bei akuter Akathisie ist Trazodon mit Erfolg verabreicht worden [15].…”

Section: Therapieoptionenunclassified

Vergiftungen mit psychotropen Substanzen

Bellmann

Joannidis

2017

Med Klin Intensivmed Notfmed

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Part 12: Cardiac Arrest in Special Situations

Cited by 660 publications

References 502 publications

The incidence, characteristics, management and outcomes of anaphylaxis in pregnancy: a population‐based descriptive study

The incidence, characteristics, management and outcomes of anaphylaxis in pregnancy: a population‐based descriptive study

Perimortem cesarean delivery and subsequent emergency hysterectomy: new strategy for maternal cardiac arrest

Vergiftungen mit psychotropen Substanzen

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