Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA.
Department of Pediatrics, United States Air Force, Brooke Army Medical Center, San Antonio TX, USA.
Int J Obstet Anesth. 2024 Nov;60:104247. doi: 10.1016/j.ijoa.2024.104247. Epub 2024 Aug 8.
As the medical complexity of pregnant patients increases, the rate of maternal morbidity has risen. Maternal cardiovascular disease is a leading cause of maternal morbidity and mortality followed closely by sepsis and infection, both of which may be associated with respiratory failure. There has been an expansion in the application of extracorporeal life support in pregnant and peripartum patients which requires obstetric anesthesiologists to understand the indications, obstetric and medical considerations, relative advantages and potential complications of this invasive technology in this population. Obstetricians and anesthesiologists who care for women on the labor floor must strive to recognize at-risk and deteriorating patients, facilitate escalation of care when appropriate, and engage consultant teams to consider the need for extracorporeal support in high-risk circumstances. This article reviews the epidemiology, indications, specific considerations, potential complications, and outcomes of extracorporeal life support in pregnant and peripartum patients.
随着孕妇医疗复杂性的增加，产妇发病率有所上升。心血管疾病是产妇发病率和死亡率的主要原因，紧随其后的是败血症和感染，两者都可能与呼吸衰竭有关。体外生命支持在妊娠和围产期患者中的应用有所扩大，这要求产科麻醉师了解该人群中该侵入性技术的适应证、产科和医学考虑因素、相对优势和潜在并发症。在产房照顾女性的妇产科医生和麻醉师必须努力识别有风险和病情恶化的患者，在适当的时候促进护理升级，并邀请顾问团队考虑在高危情况下是否需要体外支持。本文综述了体外生命支持在妊娠和围产期患者中的流行病学、适应证、具体考虑因素、潜在并发症和结局。
