Nanji Jalal A, Ansari Jessica R, Yurashevich Mary, Ismawan Johanes M, Lyell Deirdre J, Karam Amer K, Hovsepian David M, Riley Edward T
From the Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, California.
Department of Anesthesiology, Duke University School of Medicine, Durham, North Carolina.
A A Pract. 2019 Jan 15;12(2):37-40. doi: 10.1213/XAA.0000000000000836.
During a cesarean hysterectomy for placenta percreta, transesophageal echocardiography was used to monitor volume status and guide resuscitation. After delivery of the neonate but before massive surgical hemorrhage, a thrombus appeared in the inferior vena cava. Roughly 3 hours later, the patient had hemodynamic changes consistent with an intraoperative pulmonary embolism. Boluses of epinephrine stabilized the patient. An inferior vena cava filter was placed via an in situ internal jugular central venous cannula to prevent further embolic events. We believe transesophageal echocardiography is a useful monitor during surgery for placenta percreta.
在剖宫产子宫切除术中治疗穿透性胎盘植入时，经食管超声心动图用于监测容量状态并指导复苏。新生儿娩出后但在大量手术出血前，下腔静脉出现血栓。约3小时后，患者出现与术中肺栓塞一致的血流动力学变化。静脉推注肾上腺素使患者病情稳定。通过原位颈内静脉中心静脉插管放置下腔静脉滤器以防止进一步的栓塞事件。我们认为经食管超声心动图在穿透性胎盘植入手术中是一种有用的监测手段。
