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Acute Respiratory Distress Syndrome in Pregnancy
Acute respiratory distress syndrome (ARDS) is a clinical syndrome characterized by several clinical features and pathological responses involving the respiratory system primarily. Infections (viral), sepsis, and massive transfusion are the commonest causes of ARDS during pregnancy. The majority of t...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Jaypee Brothers Medical Publishers
2021
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9108786/ https://www.ncbi.nlm.nih.gov/pubmed/35615614 http://dx.doi.org/10.5005/jp-journals-10071-24036 |
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author | Pandya, Sunil T Krishna, Sai J |
author_facet | Pandya, Sunil T Krishna, Sai J |
author_sort | Pandya, Sunil T |
collection | PubMed |
description | Acute respiratory distress syndrome (ARDS) is a clinical syndrome characterized by several clinical features and pathological responses involving the respiratory system primarily. Infections (viral), sepsis, and massive transfusion are the commonest causes of ARDS during pregnancy. The majority of them recover with noninvasive ventilatory (NIV) support. NIV is safe in pregnancy provided the center is experienced and has a protocolized patient care pathway. Parturients requiring invasive mechanical ventilation are best managed in experienced centers. PaO(2)/FiO(2) targets are higher in parturients compared to nonpregnant patients. Permissive hypercapnia is not a safe option in pregnancy. In severe ARDS with refractory hypoxemia, prone ventilation is a safe option. However, it has to be done in experienced centers. Venovenous ECMO is a safe alternative option in pregnant women with refractory hypoxemia, and delivery has been prolonged to a safe viable age on ECMO. The decision to deliver and the mode of delivery have to be a multidisciplinary decision; primary criterion is maternal survival. Postdelivery, establishing maternal bonding while in ventilatory support facilitates early weaning and minimizes lactation failure. HOW TO CITE THIS ARTICLE: Pandya ST, Krishna SJ. Acute Respiratory Distress Syndrome in Pregnancy. Indian J Crit Care Med 2021; 25(Suppl 3):S241–S247. |
format | Online Article Text |
id | pubmed-9108786 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Jaypee Brothers Medical Publishers |
record_format | MEDLINE/PubMed |
spelling | pubmed-91087862022-05-24 Acute Respiratory Distress Syndrome in Pregnancy Pandya, Sunil T Krishna, Sai J Indian J Crit Care Med Invited Article Acute respiratory distress syndrome (ARDS) is a clinical syndrome characterized by several clinical features and pathological responses involving the respiratory system primarily. Infections (viral), sepsis, and massive transfusion are the commonest causes of ARDS during pregnancy. The majority of them recover with noninvasive ventilatory (NIV) support. NIV is safe in pregnancy provided the center is experienced and has a protocolized patient care pathway. Parturients requiring invasive mechanical ventilation are best managed in experienced centers. PaO(2)/FiO(2) targets are higher in parturients compared to nonpregnant patients. Permissive hypercapnia is not a safe option in pregnancy. In severe ARDS with refractory hypoxemia, prone ventilation is a safe option. However, it has to be done in experienced centers. Venovenous ECMO is a safe alternative option in pregnant women with refractory hypoxemia, and delivery has been prolonged to a safe viable age on ECMO. The decision to deliver and the mode of delivery have to be a multidisciplinary decision; primary criterion is maternal survival. Postdelivery, establishing maternal bonding while in ventilatory support facilitates early weaning and minimizes lactation failure. HOW TO CITE THIS ARTICLE: Pandya ST, Krishna SJ. Acute Respiratory Distress Syndrome in Pregnancy. Indian J Crit Care Med 2021; 25(Suppl 3):S241–S247. Jaypee Brothers Medical Publishers 2021-12 /pmc/articles/PMC9108786/ /pubmed/35615614 http://dx.doi.org/10.5005/jp-journals-10071-24036 Text en Copyright © 2021; Jaypee Brothers Medical Publishers (P) Ltd. https://creativecommons.org/licenses/by-nc/4.0/© The Author(s). 2021 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and non-commercial reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Invited Article Pandya, Sunil T Krishna, Sai J Acute Respiratory Distress Syndrome in Pregnancy |
title | Acute Respiratory Distress Syndrome in Pregnancy |
title_full | Acute Respiratory Distress Syndrome in Pregnancy |
title_fullStr | Acute Respiratory Distress Syndrome in Pregnancy |
title_full_unstemmed | Acute Respiratory Distress Syndrome in Pregnancy |
title_short | Acute Respiratory Distress Syndrome in Pregnancy |
title_sort | acute respiratory distress syndrome in pregnancy |
topic | Invited Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9108786/ https://www.ncbi.nlm.nih.gov/pubmed/35615614 http://dx.doi.org/10.5005/jp-journals-10071-24036 |
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