Pulmonary oedema associated with ritodrine infusion and betamethasone administration in premature labour.

Elliott, H R; Abdulla, U.; Hayes, P J

doi:10.1136/bmj.2.6140.799-a

Cited by 89 publications

(15 citation statements)

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“…250 or 500 mg They have also been used for the treatment of aminophylline compared to 250 or 500 ng sal-premature labour, and there are reports of pulbutamol. The results have been equally good in monary oedema developing during this treatthe reported series of about 100 patients (5, 35, ment (30,93,110,132). In this situation the 43,138).…”

Section: Intravenous Aminophylline and Intravenousmentioning

confidence: 51%

The Treatment of Status Asthmaticus

Georg

1981

Allergy

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Asthma has proved difficult to define (42, 103, in asthma often comes suddenly and unexpect-116) and physicians do not always agree about edly, and even experienced physicians may when a patient should be called asthmatic, have difficulty in judging the severity of an Status asthmaticus cannot be easier to define, attack. The patient may be a better judge in but it seems much more seldom that physicians this respect (122), but many asthmatics are not disagree about a diagnosis of status asthma-very sensitive to changes in airway obstruction, ticus. The term will be used here to denote a Rubinfeld & Pain (111) found that 15% were sustained attack of severe asthma that has not unable to sense a reduction in FEVj below 50% responded to the treatment administered by of predicted value. An objective assessment the patient and his doctor. It is a serious and ought usually to be the first step taken when potentially lethal phase of the disease and if dealing with a patient in status asthmaticus. It hospital admission is possible it will usually be can be carried out in a few minutes, and it required.provides both a baseline from which the proStatus asthmaticus is an acute aggravation gress of the patient can be assessed and a gradwhich may afflict the allergic as well as the ing of the severity of the attack, non-allergic asthmatic. It may occur at any age.The physical signs of wheezing, the use of but the risk seems to be greatest in the middle-accessory respiratory muscles and the presence aged patient with asthma of late onset. It also of pulsus paradoxus have not been found to be seems to afflict women more often than men. reliable indicators of the severity of asthma (71, In seven recent papers (7,25,58,61,70,118,121). 119) out of a total of 1,540 patients, 1,136 were Counting the heart rate is the simplest of females and 404 males, i.e. a ratio of about 3:1.objective measurements and will provide some We have now fairly good knowledge of the indication of the severity of the attack. An elecliberation of mediator substances from the trocardiogram and a chest radiograph should mast cell in the reaction with specific allergens also be available. Tachycardia is always a feature and about their possible significance in acute, of severe asthma and is related to the degree of asthmatic attacks. Yet we do not understand hypoxaemia (107). The average heart rate is what happens when the patient lapses into about [120][121][122][123][124][125][126][127][128][129][130] found an average status asthmaticus despite the use of the medi-rate of 126; Westerman (137) 139 with a range cation which in other situations has successfully from 110 to 180; Rees (107) 118, range 96-160. brought him relief Cooke et al. (25) found a heart rate above 90 in 87% of their patients and that 75% of the complications occurred in patients with a heart Objective assessment ^ , ,0•^ rate above 130. The treatment of severe asthma must reasonTwo important objective measurements that ably begin with an assessment of severity. Death any emergency ward s...

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Section: Intravenous Aminophylline and Intravenousmentioning

confidence: 51%

The Treatment of Status Asthmaticus

Georg

1981

Allergy

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“…However, the protein content in the edema fluid and the blood was not detected in that study. Despite the fact that pulmonary edema seen in the present and other reports [9,10,15,16,24,26,27] was easily and quickly controlled, it is potentially dangerous. Therefore, further studies are necessary to elucidate the mechanism of pulmonary edema during the treatment with beta-adrenergic drugs.…”

Section: Discussionmentioning

confidence: 58%

“…However, maternal treatment with tocolytic agent is not necessarily harmless. Mild to severe side effects and complications have been sporadically reported with the use of tocolytic agents [9,12,14,17,21,23,26,27,34]. Their implications in pulmonary edema are summarized in Table I.…”

Section: Discussionmentioning

confidence: 99%

“…Few reports in the American literature [10,15,16,26], detail adverse maternal cardiovascular effects of beta-adrenergic drugs, especially when they are used in combination with glucocorticoids. The European literature reports several cases of cardiorespiratory complications related to the combined usage of betamimetic drugs and glucocorticoids [9,12,24,27]. We have recently seen a potentially serious complication in a mother treated antenatally with isoxsuprine and dexamethasone.…”

Section: Introductionmentioning

confidence: 95%

See 1 more Smart Citation

Pulmonary edema occurring after isoxsuprine and dexamethasone treatment for preterm labor: Case report

Evron¹,

Samueloff²,

Mor-Yosef³

et al. 1983

Journal of Perinatal Medicine

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“…It has been shown that adrenergics lead to infarct4ike lesions [33] with the clinical picture of catecholaminmyocarditis arising from hypoxiai [4,37]. These myocardial alterations, also found after an overdose of adrenergics and in pheochromocytoma [4], have gained importance in obstetrics ever since reports have been appearing in the past few years not only of serious pulmonary complications in the form of pulmonary edema [l, 2,5,8,13,20,39,43,45,46], but also of severe myocardial damage in tocolysis with various beta-sympathicomimetics [2,6,7,31]. Also, infantile myocardiopathy after protracted tocolysis has been observed.…”

Section: Discussionmentioning

confidence: 99%