Division of Obstetric Anesthesiology, Department of Anesthesiology, Stanford University School of Medicine, USA.
Division of Surgical Critical Care, Department of Surgery, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA.
Best Pract Res Clin Anaesthesiol. 2022 May;36(1):209-225. doi: 10.1016/j.bpa.2022.02.001. Epub 2022 Feb 18.
Leading causes of intensive care unit (ICU) admission include hemorrhage, hypertensive disorders of pregnancy, and sepsis. Although the incidence of ICU admission in pregnancy may be low, this does not account for critical illness in labor and delivery or maternity unit suites, which is as high as 1-3%. Most admissions, for example, to an ICU unit occur in the postpartum period, where studies have shown a range from 62 to 92% of admissions occurring during this period. A total of 60% of maternal deaths have been reported as preventable, with a delay in diagnosis and prompt medical treatment cited as primary factors, prompting for early recognition of high-risk obstetric patients. Recently, comorbidity-based screening tools, which quantify a patient's medical comorbidity burden, have been developed and validated in predicting ICU admission and death. Noninvasive ultrasonography such as point-of-care ultrasonography becomes essential in determining hemodynamic status, guides resuscitation, and manages cardiovascular dysfunction.
导致重症监护病房（ICU）收治的主要原因包括出血、妊娠高血压疾病和败血症。尽管妊娠期间 ICU 收治的发病率可能较低，但这并未包括分娩期间或产科套房的危急疾病，其发病率高达 1-3%。例如，大多数 ICU 收治患者发生在产后期间，研究显示在此期间收治的患者比例范围为 62%至 92%。据报道，60%的产妇死亡是可以预防的，诊断延迟和及时治疗被认为是主要因素，因此需要及早识别高危产科患者。最近，基于合并症的筛查工具已被开发并验证，用于预测 ICU 收治和死亡，这些工具量化了患者的合并症负担。床旁超声等非侵入性超声在确定血流动力学状态、指导复苏和治疗心血管功能障碍方面变得至关重要。
