How safe is the prone position in acute respiratory distress syndrome at late pregnancy?

Samanta, Sukhen; Samanta, Sujay; Wig, Jai Dev; Baronia, Arvind Kumar

doi:10.1016/j.ajem.2013.12.021

Cited by 54 publications

(46 citation statements)

References 7 publications

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“…Case reports of proning in the second and third trimesters of pregnancy provide reassurance about its safety, and centers skilled at proning patients should be similarly adept at safely proning a pregnant patient. 12 Prone positioning in pregnant patients should be done with support of the hips and chest, and aimed at reducing abdominal pressure. ►Fig.…”

Section: Obstetric Concerns In Mechanical Ventilationmentioning

confidence: 99%

Putting It All Together: Clinical Considerations in the Care of Critically Ill Obstetric Patients with COVID-19

et al. 2020

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Pregnant patients with severe acute respiratory syndrome coronavirus 2, the virus responsible for the clinical condition newly described in 2019 as coronavirus disease 2019 (COVID-19) and illness severity to warrant intensive care have a complex disease process that must involve multiple disciplines. Guidelines from various clinical societies, along with direction from local health authorities, must be considered when approaching the care of an obstetric patient with known or suspected COVID-19. With a rapidly changing landscape, a simplified and cohesive perspective using guidance from different clinical society recommendations regarding the critically-ill obstetric patient with COVID-19 is needed. In this article, we synthesize various high-level guidelines of clinical relevance in the management of pregnant patients with severe disease or critical illness due to COVID-19. Key Points

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Section: Obstetric Concerns In Mechanical Ventilationmentioning

confidence: 99%

Putting It All Together: Clinical Considerations in the Care of Critically Ill Obstetric Patients with COVID-19

et al. 2020

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“…This also allows for anterior displacement of uterus off of the inferior vena cava, which is necessary for adequate venous return after 20 weeks gestation. Close monitoring of mother and fetus including continuous fetal cardiotocography should be in place if the fetus is of viable age [42,43].…”

Section: Prone Ventilationmentioning

confidence: 99%

Respiratory Diseases of Pregnancy

Glass

Zehrer

Al‐Khafaji

2020

Evidence-Based Critical Care

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“…Reduced lower esophageal sphincter pressure may increase the risk of gastric acid reflux and aspiration, especially in the supine position. Although prone positioning has been used in respiratory failure in pregnancy, 20,21 the presence of the gravid uterus makes this position especially challenging.…”

Section: Patient Positioningmentioning

confidence: 99%

General Care of the Pregnant Patient in the Intensive Care Unit

Crozier

2017

Semin Respir Crit Care Med

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Pregnant women represent a small subset of all intensive care unit (ICU) admissions and may require intensive care for "obstetric" or "nonobstetric" reasons. Women may be admitted to the ICU at any stage of pregnancy or in the postpartum period. Pregnancy may be discovered at the time of admission to the ICU. Pregnancy impacts on ICU care in a variety of ways and requires a multidisciplinary approach to management. Pregnancy is associated with considerable physiological changes that affect most organ systems, including an expansion in blood volume, an increase in minute ventilation, and an increased risk of thrombosis. The enlarging uterus may be associated with mechanical complications due to compression and displacement of other structures. The growing fetus places considerable demands upon the mother, being reliant on maternal systems for oxygenation, nutrition and disposal of carbon dioxide, and other waste products. This "second patient" must be considered when managing the pregnant woman. Optimal management of the mother usually constitutes best treatment for the fetus. Maternal shock and physiological disturbance, medications, and ionizing radiation from diagnostic imaging may have harmful effects on the unborn child. Delivery of the fetus for either maternal or fetal indications may be necessary and should be planned for, even if considered unlikely to be required. Care of the postpartum woman has its own challenges, including managing lactation and facilitating mother/infant contact. In this article, the general care aspects of ICU treatment of the pregnant woman will be discussed, including monitoring, physiological target setting, and general supportive care.

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How safe is the prone position in acute respiratory distress syndrome at late pregnancy?

Cited by 54 publications

References 7 publications

Putting It All Together: Clinical Considerations in the Care of Critically Ill Obstetric Patients with COVID-19

Putting It All Together: Clinical Considerations in the Care of Critically Ill Obstetric Patients with COVID-19

Respiratory Diseases of Pregnancy

General Care of the Pregnant Patient in the Intensive Care Unit

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