Handa F, Tanaka M, Miyabe M, Toyooka H
Department of Anesthesia, University of Tsukuba, Ibaraki.
Masui. 1997 Nov;46(11):1492-5.
A 37-year-old parturient with severe preeclampsia accompanied by pulmonary edema underwent emergency cesarean section. Pulmonary artery (PA) catheter inserted while the patient was awake revealed hyperdynamic state with increased cardiac index and preload, and decreased systemic vascular resistance. Epidural anesthesia and analgesia were provided with a satisfactory outcome. Monitoring of PA pressure and cardiac index was continued postoperatively in ICU for fluid management. We conclude that preoperative PA catheterization provides useful hemodynamic information in severe preeclamptic patients associated with persistent oliguria, pulmonary edema and hyperdynamic state.
一名37岁患有重度子痫前期并伴有肺水肿的产妇接受了急诊剖宫产。在患者清醒时插入肺动脉(PA)导管,结果显示为高动力状态,心脏指数和前负荷增加,全身血管阻力降低。给予硬膜外麻醉和镇痛,效果满意。术后在重症监护病房(ICU)继续监测肺动脉压力和心脏指数以进行液体管理。我们得出结论,术前肺动脉插管可为伴有持续性少尿、肺水肿和高动力状态的重度子痫前期患者提供有用的血流动力学信息。