Eisenmenger Syndrome (ES) is congenital heart disease with pulmonary hypertension and shunting turning from right to left. The resistance of pulmonary vascular more than 7.5 mmHg/L/min. The right ventricle and pulmonary artery always enlarge. During pregnancy, there will be hemodynamic changes that will affect the ES. It can be understood the possible dangers that can occur, like right heart failure; an increase in pulmonary arteries or the aggravation of pulmonary hypertension because there is no decrease in pulmonary resistance; A sudden decrease in venous return in supine hypotension syndrome can cause a relative increase in pulmonary arterial pressure so as to aggravate pulmonary hypertension and reverse shunting.Physiological effects of inhaled nitric oxide (INO) therapy cause selective pulmonary vasodilation: Hypoxia alveoli causes reversible vasoconstriction, thereby increasing pulmonary wedge pressure. INO can lower it. Moderate cardiac output and systematic arterial pressure are not affected; Selective in pulmonary because it is activated by hemoglobin; Selective vasodilation in the ventilated area, local hypoxia alveoli constricts the surrounding vascular tissue and redistributes blood flow to the ventilated lungs better and higher intraalveolar oxygen pressure. INO enhances this mechanism by increasing blood flow through a well-ventilated lung; Bronchodilators; Pulmonary surfactant, The combination of high concentrations of inspired oxygen and high concentrations of INO reduces the minimum surfactant surface tension.Keywords: Inhalation Nitric Oxides, Pregnancy, Eisenmenger Syndrome
Eisenmenger Syndrome is congenital heart disease with pulmonary hypertension and shunting turning from right to left. The resistance of pulmonary vascular more than 7.5 mmHg/L/min. The right ventricle and pulmonary artery always enlarge. Physiological effects of inhaled nitric oxide therapy cause selective pulmonary vasodilation: Hypoxia alveoli causes reversible vasoconstriction, thereby increasing pulmonary wedge pressure. Inhaled nitric oxide can lower it. Moderate cardiac output and systematic arterial pressure are not affected; Selective in pulmonary because it is activated by hemoglobin; Selective vasodilation in the ventilated area, local hypoxia alveoli constricts the surrounding vascular tissue and redistributes blood flow to the ventilated lungs better and higher intraalveolar oxygen pressure. Inhaled nitric oxide enhances this mechanism by increasing blood flow through a well-ventilated lung; Bronchodilators; Pulmonary surfactant, The combination of high concentrations of inspired oxygen and high concentrations of Inhaled nitric oxide reduces the minimum surfactant surface tension.
Venous thromboembolism is both more common and more complex to diagnose in patients who are pregnant than in those who are not pregnant. Pulmonary embolism and deep-vein thrombosis are the two components of a single disease called venous thromboembolism. Pulmonary embolism is the leading cause of maternal death in the developed world. Delayed diagnosis, delayed or inadequate treatment, and inadequate thromboprophylaxis account for many of the deaths due to venous thromboembolism. Successful strategies for the management of venous thromboembolism in nonpregnant patients have been established. However, many of the recommendations for the treatment of pregnant patients who have venous thromboembolism are not based on high-quality data; rather, they are derived from observational studies and extrapolation from studies involving nonpregnant patients. The purpose of this review is to provide a practical approach to the diagnosis, management, and prevention of venous thromboembolism in pregnant patients. ABSTRAKTromboemboli vena sering ditemukan dan lebih kompleks untuk didiagnosis pada pasien yang hamil daripada pada mereka yang tidak hamil. Pulmonary embolism dan deep-vein thrombosis adalah dua komponen dari satu penyakit yang disebut tromboemboli vena. Emboli paru adalah penyebab utama kematian ibu di negara maju. Diagnosis tertunda, pengobatan tertunda atau tidak memadai, dan profil tromboprofilaksis yang tidak memadai menyebabkan banyak kematian akibat tromboemboli vena. Strategi yang berhasil untuk pengelolaan tromboemboli vena pada pasien yang tidak hamil telah ditetapkan. Namun, banyak rekomendasi untuk pengobatan pasien hamil yang memiliki tromboemboli vena tidak didasarkan pada data berkualitas tinggi. Sebaliknya, mereka berasal dari penelitian observasional dan ekstrapolasi dari penelitian yang melibatkan pasien yang tidak hamil. Tujuan dari tinjauan ini adalah untuk memberikan pendekatan praktis terhadap diagnosis, manajemen, dan pencegahan tromboemboli vena pada pasien hamil.
Persistent pulmonary hypertension of the newborn (PPHN) is a condition that occurs due to increased resistance to blood vessels in the lungs that occur persistently after the baby is born. This can be attributed to congenital heart disease such as right-to-left shunts through foramen ovale (PFO) or patent ductus arteriosus (PDA) due to an error transition fetal blood circulation to the neonate. Although PPHN is always associated with births in post-term babies, PPHN cases are often found in preterm babies. Chances of babies born with PPHN are quite large, at 1.9% per 1000 live births. PPHN can be fatal, causing mortality rates ranging from 4 to 33%. The incidence of preterm births in Indonesia is estimated at 7-14%, around 459,200 - 900,000 babies per year. This study aimed to prove the relationship between premature babies and persistent pulmonary hypertension of the newborn (pphn) in Sidoarjo Regional Hospital and to know the characteristics and analyze these variables. This research used crossed sectional studied design; the population was all preterm babies in the NICU at Sidoarjo regional hospital. All samples are from medical records in January-December 2018. There is a significant difference between preterm babies and PPHN (p < 0.05); besides, the results from Spearman's correlation analysis obtained a correlation coefficient (ρ) = 0.485. In the cross-tabulation analysis, the result of the proportion with the highest correlation was Late Preterm babies with severe PPHN of 46.7%. It can be concluded that there is a relationship between premature babies and PPHN in Sidoarjo regional hospital..Keywords : Persistent pulmonary hypertension of the newborn, PPHN, Preterm BabiesCorrespondence : aisyahhelmadevithalib@gmail.com
Infeksi HIV sering dikaitkan dengan gangguan jantung. Namun demikian, keterlibatan jantung pada populasi pasien HIV sering kurang didiagnosis atau dikaitkan dengan salah pada proses penyakit non-jantung lainnya. Efusi perikardial (PE) tidak jarang ditemukan pada pasien dengan HIV / AIDS yang dilaporkan mempengaruhi hampir 5% pasien HIV. Telah dibuktikan bahwa tamponade jantung, keadaan darurat hemodinamik yang serius sebagai akibat efusi perikardial, tidak perlu dikaitkan dengan efusi besar tetapi dengan cepatnya akumulasi PE dan kurangnya kepatuhan kompensasi dalam ruang perikardial. Selain itu, tingkat keparahan PE pada pasien HIV / AIDS telah terbukti berkorelasi dengan prognosis buruk sebelum meluasnya penggunaan terapi antiretroviral (ART), meskipun demikian, implikasi prognostik PE tidak dapat ditentukan karena HAART telah mengubah riwayat alami PE. .Kata kunci : Efusi perikardial; Tamponade Jantung; HIV; AIDS.
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