Assuntos
Anticoagulantes , Cateteres de Demora , Heparina , Artérias , Testes de Coagulação Sanguínea , HumanosRESUMO
A case of life-threatening respiratory distress during a Caesarean section under spinal anaesthesia is reported. Possible causes of the event including anaphylactoid reactions and the methods of their diagnosis are discussed. The most likely cause of the episode was felt to be an anaphylactoid reaction to Syntocinon.
Assuntos
Anafilaxia/induzido quimicamente , Cesárea , Complicações Intraoperatórias , Ocitocina/efeitos adversos , Insuficiência Respiratória/induzido quimicamente , Doença Aguda , Adulto , Anestesia Obstétrica , Raquianestesia , Feminino , Humanos , GravidezRESUMO
An overdose of the semisynthetic, hallucinogenic amphetamine 3,4-methylenedioxymethamphetamine resulted in convulsions, hyperthermia, hyperkalaemia and rhabdomyolysis. The patient's management, which included the use of dantrolene, is discussed.
Assuntos
3,4-Metilenodioxianfetamina/análogos & derivados , Dantroleno/uso terapêutico , Transtornos Relacionados ao Uso de Substâncias/tratamento farmacológico , Adulto , Humanos , Unidades de Terapia Intensiva , Ventilação com Pressão Positiva Intermitente , Masculino , N-Metil-3,4-Metilenodioxianfetamina , Transtornos Relacionados ao Uso de Substâncias/fisiopatologiaRESUMO
The pressor and catecholamine responses to laryngoscopy and intubation were studied in nine patients with pregnancy-induced hypertension (PIH) and in eight normotensive controls. Five of the PIH patients had received oral labetalol as antihypertensive therapy. Mean arterial pressure (MAP) increased significantly from the pre-induction value in all groups 1 min after intubation, and also at 3 min in those with PIH who had not received labetalol. Arterial pressure was significantly greater in both PIH groups than in the control group at all times. However, the percentage increase in MAP on intubation was significantly less in the labetalol treated group than in either the untreated or the control groups. There were no significant differences between the groups in plasma concentrations of either noradrenaline or adrenaline; noradrenaline concentration increased significantly after intubation only in the control group. Labetalol appears to confer some protection against the pressor response to intubation in parturients with PIH.
Assuntos
Cesárea , Hipertensão/fisiopatologia , Intubação Intratraqueal , Norepinefrina/sangue , Complicações Cardiovasculares na Gravidez/fisiopatologia , Adulto , Pressão Sanguínea/efeitos dos fármacos , Feminino , Frequência Cardíaca , Humanos , Hipertensão/tratamento farmacológico , Labetalol/uso terapêutico , Gravidez , Complicações Cardiovasculares na Gravidez/tratamento farmacológicoRESUMO
A case of peripartum cardiomyopathy that occurred together with pre-eclampsia is described. This gave rise to pulmonary oedema at 36 weeks' gestation. Intensive care management and the need for invasive monitoring, especially pulmonary artery wedge pressure, of patients who develop pulmonary oedema in the peripartum period is discussed.