Kislovskiy Yasaswi, Hauspurg Alisse, Donadee Chenell, Sakamoto Sara, Murugan Raghavan
Department of Obstetrics and Gynecology, Women's Institute, Allegheny Health Network, Pittsburgh, Pennsylvania.
Department of Obstetrics, Gynecology, and Reproductive Sciences, UPMC Magee-Women's Hospital, Pittsburgh, Pennsylvania.
AJP Rep. 2024 Apr 16;14(2):e111-e119. doi: 10.1055/a-2207-9917. eCollection 2024 Apr.
We sought to describe characteristics of mechanically ventilated pregnant patients, evaluate utilization of low-tidal-volume ventilation (LTVV) and high-tidal-volume ventilation (HTVV) by trimester, and describe maternal and fetal outcomes by ventilation strategy. This is a retrospective cohort study of pregnant women with mechanical ventilation for greater than 24 hours between July 2012 and August 2020 at a tertiary care academic medical center. We defined LTVV as average daily tidal volume 8 mL/kg of less of predicted body weight, and HTVV as greater than 8 mL/kg. We examined demographic characteristics, maternal and fetal characteristics, and outcomes by ventilation strategy. We identified 52 ventilated pregnant women, 43 had LTVV, and 9 had HTVV. Acute respiratory distress syndrome occurred in 73% ( = 38) of patients, and infection was a common indication for ventilation ( = 33, 63%). Patients had LTVV more often than HTVV in all trimesters. Obstetric complications occurred frequently, 21% ( = 11) experienced preeclampsia or eclampsia, and among 43 patients with available delivery data, 60% delivered preterm ( = 26) and 16% had fetal demise ( = 7). LTVV was utilized more often than HTVV among pregnant women in all trimesters. There was a high prevalence of maternal and fetal morbidity and fetal mortality among our cohort. Our center utilized low tidal more often than high-tidal-volume ventilation during all trimesters of pregnancy.Prone positioning can be performed at advanced gestations.Infection is a common cause of antepartum ventilation.
我们试图描述机械通气的孕妇的特征，评估不同孕期低潮气量通气（LTVV）和高潮气量通气（HTVV）的使用情况，并按通气策略描述母婴结局。 这是一项回顾性队列研究，研究对象为2012年7月至2020年8月在一家三级医疗学术医学中心接受机械通气超过24小时的孕妇。我们将LTVV定义为平均每日潮气量小于预测体重的8 mL/kg，将HTVV定义为大于8 mL/kg。我们通过通气策略检查了人口统计学特征、母婴特征和结局。 我们确定了52名接受通气的孕妇，其中43名采用LTVV，9名采用HTVV。73%（n = 38）的患者发生急性呼吸窘迫综合征，感染是通气的常见指征（n = 33，63%）。在所有孕期中，患者使用LTVV的频率高于HTVV。产科并发症频繁发生，21%（n = 11）的患者发生先兆子痫或子痫，在43名有分娩数据的患者中，60%（n = 26）早产，16%（n = 7）发生胎儿死亡。 在所有孕期的孕妇中，LTVV的使用频率高于HTVV。我们的队列中母婴发病率和胎儿死亡率很高。我们中心在孕期的所有阶段使用低潮气量通气的频率高于高潮气量通气。在孕晚期可以进行俯卧位通气。感染是产前通气的常见原因。
