Abstract
Women with structural cardiac or coronary artery disease may have an attenuated ability to adapt to the cardiovascular changes associated with pregnancy. The use of cardiopulmonary bypass (CPB) may be necessary and unavoidable for many urgent or emergent cardiac surgical repairs. Accurate maternal and fetal risk assessment prior to surgery is fundamental for preoperative care. CPB may cause significant alterations in patient physiology, with virtually every organ system affected. The main pathophysiological changes that can affect the fetus under CPB are uterine contraction, placental hypoperfusion, and fetal hypoxia. There are three primary aims in the anesthetic management of patients undergoing CPB: providing safe maternal hemodynamic management, avoiding teratogenic agents, and minimizing effects of CPB that may induce premature labor. The application of cardioplegia may need to be more frequent with the maintenance of high flows during CPB, especially if normothermia or only mild hypothermia is employed.
| Original language | English (US) |
|---|---|
| Title of host publication | Critical Care Obstetrics |
| Publisher | wiley |
| Pages | 285-302 |
| Number of pages | 18 |
| ISBN (Electronic) | 9781119129400 |
| ISBN (Print) | 9781119129370 |
| DOIs | |
| State | Published - Jan 1 2018 |
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Keywords
- Anesthetic management
- Cardioplegia
- Cardiopulmonary bypass
- Fetal hypoxia
- Patient physiology
- Pregnancy
ASJC Scopus subject areas
- Medicine(all)
Cite this
Cardiopulmonary bypass. / McQuitty, Alexis.
Critical Care Obstetrics. wiley, 2018. p. 285-302.Research output: Chapter in Book/Report/Conference proceeding › Chapter
}
TY - CHAP
T1 - Cardiopulmonary bypass
AU - McQuitty, Alexis
PY - 2018/1/1
Y1 - 2018/1/1
N2 - Women with structural cardiac or coronary artery disease may have an attenuated ability to adapt to the cardiovascular changes associated with pregnancy. The use of cardiopulmonary bypass (CPB) may be necessary and unavoidable for many urgent or emergent cardiac surgical repairs. Accurate maternal and fetal risk assessment prior to surgery is fundamental for preoperative care. CPB may cause significant alterations in patient physiology, with virtually every organ system affected. The main pathophysiological changes that can affect the fetus under CPB are uterine contraction, placental hypoperfusion, and fetal hypoxia. There are three primary aims in the anesthetic management of patients undergoing CPB: providing safe maternal hemodynamic management, avoiding teratogenic agents, and minimizing effects of CPB that may induce premature labor. The application of cardioplegia may need to be more frequent with the maintenance of high flows during CPB, especially if normothermia or only mild hypothermia is employed.
AB - Women with structural cardiac or coronary artery disease may have an attenuated ability to adapt to the cardiovascular changes associated with pregnancy. The use of cardiopulmonary bypass (CPB) may be necessary and unavoidable for many urgent or emergent cardiac surgical repairs. Accurate maternal and fetal risk assessment prior to surgery is fundamental for preoperative care. CPB may cause significant alterations in patient physiology, with virtually every organ system affected. The main pathophysiological changes that can affect the fetus under CPB are uterine contraction, placental hypoperfusion, and fetal hypoxia. There are three primary aims in the anesthetic management of patients undergoing CPB: providing safe maternal hemodynamic management, avoiding teratogenic agents, and minimizing effects of CPB that may induce premature labor. The application of cardioplegia may need to be more frequent with the maintenance of high flows during CPB, especially if normothermia or only mild hypothermia is employed.
KW - Anesthetic management
KW - Cardioplegia
KW - Cardiopulmonary bypass
KW - Fetal hypoxia
KW - Patient physiology
KW - Pregnancy
UR - http://www.scopus.com/inward/record.url?scp=85060647770&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85060647770&partnerID=8YFLogxK
U2 - 10.1002/9781119129400.ch17
DO - 10.1002/9781119129400.ch17
M3 - Chapter
SN - 9781119129370
SP - 285
EP - 302
BT - Critical Care Obstetrics
PB - wiley
ER -