一例采用主动脉内球囊阻断术的剖宫产子宫切除术麻醉管理：Fontan循环合并胎盘植入患者的病例报告
Anesthetic management of cesarean hysterectomy using intra-aortic balloon occlusion in a patient with Fontan circulation and placenta increta: a case report.
作者信息
Ohsugi Eriko, Kato Rie, Hosokawa Yuki, Oe Katsunori
机构信息
Department of Anesthesiology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-Ku, Tokyo, 142-8555, Japan.
出版信息
JA Clin Rep. 2023 Apr 24;9(1):20. doi: 10.1186/s40981-023-00611-1.
BACKGROUND
In patients with Fontan circulation, hemorrhage can cause life-threatening circulatory collapse, since Fontan circulation strongly depends on the preload. Furthermore, parturients with placenta accreta spectrum are at a high risk of rapid and massive hemorrhage. Herein, we report the case of an intra-aortic balloon occlusion used for a Fontan-palliated parturient with placenta increta with successful anesthetic management.
CASE PRESENTATION
A 35-year-old-female with Fontan circulation diagnosed with placenta increta underwent a cesarean hysterectomy. The main goal during anesthetic management was to maintain sufficient preload. Infrarenal intra-aortic balloon occlusion was used to reduce intraoperative hemorrhage. The hemodynamic changes caused were well tolerated in this case.
CONCLUSIONS
Intra-aortic balloon occlusion was used in a Fontan-palliated parturient with placenta increta with successful anesthetic management.
背景
在接受Fontan循环手术的患者中，出血可导致危及生命的循环衰竭，因为Fontan循环严重依赖前负荷。此外，患有胎盘植入谱系疾病的产妇发生快速大量出血的风险很高。在此，我们报告一例主动脉内球囊阻断术用于一名患有胎盘植入的Fontan循环产妇并成功实施麻醉管理的病例。
病例介绍
一名35岁诊断为胎盘植入的Fontan循环女性患者接受了剖宫产子宫切除术。麻醉管理的主要目标是维持足够的前负荷。肾下主动脉内球囊阻断术用于减少术中出血。该病例中引起的血流动力学变化耐受性良好。
结论
主动脉内球囊阻断术用于一名患有胎盘植入的Fontan循环产妇并成功实施麻醉管理。
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