Briones GJC, García OED, Díaz de León PM, Guerrero HA, Sandoval AOI

Language: Spanish
References: 5
Page: 100-105
PDF size: 188.80 Kb.

ABSTRACT

Introduction: Care of obstetrical hemorrhage requires surgical competence with skills and abilities, control the hemodynamics, based on the lost volume, base and lactate to evaluate the impact of hypoxic-ischemic and the impact to white body.
Objective: Describe the hemodynamic behavior and hypoxic-ischemic patients with obstetric hemorrhage impact.
Site: Intensive Care Unit of Gynecology and obstetrics of the Hospital General de Mexico «Dr. Eduardo Liceaga».
Material and methods: Series of 25 patients with acute obstetric hemorrhage, with laboratory tests, blood gases and thoracic bioimpedance for monitoring hemodynamic, evaluating treatment and results using descriptive and inferential statistics.
Results: Hemorrhage of 2,532 ± 1,368 mL (47.1 ± 17.7%), 3.1 lactate ± 1.6, deficit of basis of 10.0 ± 1.4, spending heart of 3.8 ± 2.0, 1,310-peripheral vascular resistance ± 259, blood pressure average of 72.8 ± 11.0, pressure 12.8 coloidosmotica ± 3.0 and index of Briones of 0.17 ± 0.04, volume replacement; 6,138 ± 3,486: crystalloid 60%, colloids 19%, and procedures 18%, all patients required some hemostatic surgical procedure, source of bleeding: 48%, 32%, vaginal tears placental accreta uterine hypotonia, incomplete abortion, and 20%, surgical management ruptured ectopic pregnancy: 74% c-section-hysterectomy and 16%, bilateral hypogastric arteries ligation. We show that correlation there is between cardiac output and systemic vascular resistance, so the lack of volume is apparent.
Findings: Hemorrhagic shock is a syndrome secondary to acute loss of circulating volume, with hemodynamic dysfunction, low availability of oxygen, cell cellular dysfunction and multiorgan damage.

REFERENCES

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3. Sosa GJO, Balderas JJ, León VJY. Hemorragia obstétrica en la unidad de cuidados intensivos, pp. 223-251. En: Briones GJC, Díaz de León PM. Clínicas Quirúrgicas de la Academia Mexicana de Cirugía. Volumen XVIII, tomo 1 Equipo de Respuesta Rápida en Urgencias Obstétricas, Editorial Alfil, 2013 México D.F.

4. Briones GJC, Briones VCG, Meneses CJ, Sosa JO. Cuidados intensivos en la paciente obstétrica, pp. 309-314. En: Díaz de León PM, Briones GJC, Aristondo MGA. Medicina aguda. 2a. edición, Editorial Prado, 2014 México, D.F.

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