Point-of-Care Thromboelastometry in the Management of Acute Obstetric Hemorrhage

Snegovskikh, Denis; Walton, Zachary D.; Souzdalnitski, Dmitri

doi:10.1007/s13669-016-0172-0

Cited by 2 publications

(2 citation statements)

References 26 publications

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“…Coupled with ROTEM to select blood products, we avoided overtransfusion and RV strain. 13 – 15 Early detection and aggressive correction of the hypofibrinogenemia was key to the successful management of the coagulopathy.…”

Section: Discussionmentioning

confidence: 99%

Successful Resuscitation of Maternal Cardiac Arrest With Disseminated Intravascular Coagulation Guided by Rotational Thromboelastometry and Transesophageal Echocardiography: A Case Report

Brown

Barrett

Lee³

et al. 2018

A&A Practice

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We present a case of maternal cardiac arrest during an elective cesarean delivery. Transesophageal echocardiography identified a large pulmonary artery mass, and guided resuscitation efforts. After return of spontaneous circulation, the patient developed disseminated intravascular coagulation with massive hemorrhage. Blood product selection and volume replacement were guided by rotational thromboelastometry and transesophageal echocardiography, respectively. Correction of coagulopathy was observed clinically and confirmed by rotational thromboelastometry. The patient fully recovered without neurological deficit.

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Section: Discussionmentioning

confidence: 99%

Successful Resuscitation of Maternal Cardiac Arrest With Disseminated Intravascular Coagulation Guided by Rotational Thromboelastometry and Transesophageal Echocardiography: A Case Report

Brown

Barrett

Lee³

et al. 2018

A&A Practice

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“…The use of fibrinogen is also important in patients in whom it has decreased 1 g/dl as they have a 2.6-fold greater risk of severe bleeding. Fibrinogen should be administered to maintain its value between 150 and 200 mg/dl [43].…”

Section: Coagulopathy and Blood-derived Productsmentioning

confidence: 99%

Resuscitation in Obstetric Hemorrhage: “Less Is More”

Antonio Villalobos Silva,

Isaí Aguilera Olvera,

Antonio Aguirre Gómez

2024

Recent Updates in Intensive Care Medicine [Working Title]

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Obstetric hemorrhage accounts for one-third of maternal deaths worldwide. Risk factors have been identified, being common in developing countries. Mortality due to this complication has increased in recent years in countries like United States. Therefore, intensivists should be aware of the clinical tools and technology available for diagnosing and treating patients with severe hemorrhage. The main goal of resuscitation is to restore tissue oxygen delivery and perform initial management with crystalloids, while evaluating perfusion windows, which has been a long-time study, followed by transfusion of blood products (if initially not available) with the aim of restoring circulating volume. In recent years, complications of a large volume of fluids during resuscitation have proved harmful, as fluid accumulation in different organs such as the brain, heart, lung, and kidneys may cause edema, decreased lactate clearance, oxygen diffusion, weaning failure, increased hospital stay, and coagulopathy. The “less is more” approach is a strategy based on optimizing resources such as time to evaluation, treatment with fluids and blood products, clinical and laboratory data to assess severity to provide stabilization, and avoiding common complications in the ICU due to severe hemorrhage.

show abstract

Point-of-Care Thromboelastometry in the Management of Acute Obstetric Hemorrhage

Cited by 2 publications

References 26 publications

Successful Resuscitation of Maternal Cardiac Arrest With Disseminated Intravascular Coagulation Guided by Rotational Thromboelastometry and Transesophageal Echocardiography: A Case Report

Successful Resuscitation of Maternal Cardiac Arrest With Disseminated Intravascular Coagulation Guided by Rotational Thromboelastometry and Transesophageal Echocardiography: A Case Report

Resuscitation in Obstetric Hemorrhage: “Less Is More”

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