Critical Care Obstetrics, 4th edition PDF
Preview Critical Care Obstetrics, 4th edition
Critical Care Obstetrics Fourth Edition Editopin-Chief Gary A. Dildy 111, MD Professor, Department of Obstetrics and Gynecology Louisiana State University Health Sciences Center, New Orleans, Louisiana Editors Michael A. Belfort, MBBCH, MD, PhD Professor, Department of Obstetrics and Gynecology University of Utah Health ServicesC enter, Salt Lake City, Utah Director, Department of Maternal Fetal Medicine Utah Valley Regional Medical Center, Provo, Utah George R. Saade, MD Professor, Department of Obstetrics and Gynecology Divisions of Maternal-Fetal Medicine and Reproductive Sciences Director, Maternal-Fetal Medicine Fellowship The University of Texas Medical Branch, Galveston, Texas Jeffrey P. Phelan, MD, JD Vice Chairman and Director of Quality Assurance, Department of Obstetrics and Gynecology Citrus Valley Medical Center, West Covina, California President and Director Clinical Research Childbirth Injury Prevention Foundation, Pasadena, California Gary D. V. Hankins, MD Professor and Vice Chairman, Department of Obstetrics and Gynecology Chief, Division of Maternal Fetal Medicine The University of Texas Medical Branch, Galveston, Texas Steven L. Clark, MD Professor, Department of Obstetrics and Gynecology University of Utah Health ServicesC enter LDS Hospital, Salt Lake City, Utah Blackwell Science Critical Care Obstetrics Critical Care Obstetrics Fourth Edition Editopin-Chief Gary A. Dildy 111, MD Professor, Department of Obstetrics and Gynecology Louisiana State University Health Sciences Center, New Orleans, Louisiana Editors Michael A. Belfort, MBBCH, MD, PhD Professor, Department of Obstetrics and Gynecology University of Utah Health ServicesC enter, Salt Lake City, Utah Director, Department of Maternal Fetal Medicine Utah Valley Regional Medical Center, Provo, Utah George R. Saade, MD Professor, Department of Obstetrics and Gynecology Divisions of Maternal-Fetal Medicine and Reproductive Sciences Director, Maternal-Fetal Medicine Fellowship The University of Texas Medical Branch, Galveston, Texas Jeffrey P. Phelan, MD, JD Vice Chairman and Director of Quality Assurance, Department of Obstetrics and Gynecology Citrus Valley Medical Center, West Covina, California President and Director Clinical Research Childbirth Injury Prevention Foundation, Pasadena, California Gary D. V. Hankins, MD Professor and Vice Chairman, Department of Obstetrics and Gynecology Chief, Division of Maternal Fetal Medicine The University of Texas Medical Branch, Galveston, Texas Steven L. Clark, MD Professor, Department of Obstetrics and Gynecology University of Utah Health ServicesC enter LDS Hospital, Salt Lake City, Utah Blackwell Science 02 004 by Blackwell Science a Blackwell Publishing company Blackwell Publishing, lnc., 350 Main Street, Malden, Massachusetts 02148-5020, USA Blackwell Publishing Ltd, 9600 Garsington Road, Oxford OX4 ZDQ, UK Blackwell Science Asia Pty Ltd, 550 Swanston Street, Carlton, Victoria 3053, Australia All rights reserved. No part of this publication may be reproduced in any form or by any electronic or mechanical means, including information storage and retrieval systems, without permission in writing from the publisher, except by a reviewer who may quote brief passages in a review. 06 5432 ISBN 1 39 784-632-04632-4 ISBN 10: 0-632-04632-5 Library of Congress Cataloging-in-Publication Data Criticalcareobstetrics.4thed./ editedbyGaryA.DildyIIl . . . [etal.]. p. ;c m. Includes bibliographical references and index. ISBN 0-63244632-5 1. Pregnancyxomplications. 2. Obstetrical emergencies. [DNLM 1. Pregnancy Complicatiowtherapy. 2. Critical Care-Pregnancy WQ24oC93392003I I. Dildy, GaryA. RG571.C68 2003 618.3’028--dc22 Acquisitions:L aura DeYoung Development: Julia Casson Production: Debra Lally, Lorna Hind Cover design: Jennifer Kowalewski Typesetter: S N P Best-set Typesetter Ltd., Hong Kong Printed and bound by Sheridan Books in Chelsea, M, USA For further information on Blackwell Publishing, visit OUT website: www.blackwellpublishing.com Notice: The indications and dosages of all drugs in this book have been recommended in the medical literature and conform to the practices of the general community. The medications described do not necessarily have specifica pproval by the Food and Drug Administration for use in the diseases and dosages for which they are recommended. The package insert for each drug should be consulted for use and dosage as approved by the FDA. Because standards for usage change, it is advisable to keep abreast of revised recommendations, particularly those concerning new drugs. Contents Preface, vii 10 Blood component replacement therapy, 162 David A.S acks Dedications, viii 11 Hyperalimentation, 184 Contributors, ix JeffreyP . Phelan 12 Dialysis, 191 Gail L. Seiken 1. Introductiont o critical care obstetrics 13 Cardiopulmonary bypass, 199 1 Epidemiology of critical illness and outcomes in Audrey S. Alleyneand Peter L. Bailey pregnancy, 3 14 Noninvasive monitoring, 211 Cande V. Ananth and John C. Smulian John Anthonya nd Michael A.B elfort 2 Organizing a critical care obstetric unit, 13 15 Pulmonary artery catheterization, 219 Cornelia R. Graves G a yA .D ildyllland Steven L. Clark 11. Pregnancybhysiology IV. Disease processes 3 Pregnancy-induced physiologic alterations, 19 16 Seizures and status epilepticus, 227 Errol R. Nomitz,J ulian N .R obinson,a nd Fergal D. Malone Tawnya Constantino and Michael W. Varner 4 Maternal-fetal blood gas physiology, 43 17 Acute spinal cord injury, 233 Renee A.B obrowski SheylR odts-Palenikand James N.M artin,Jr 5 Fluid and electrolyte balance, 60 18 Cerebrovascular accidents, 240 WilliamE . Scorza and AnthonyS cardella Mark W. Tomlinsona nd Bernard Gonik 19 Cardiac disease, 252 Michael R. Foley 111. Procedures and interventions 20 Thromboembolicd isease, 275 6 Cardiopulmonary resuscitation, 87 Donna Dizon-Townson,S hailen S . Shah,and JeffreyP . Phelan Nancy A.H ueppchen and Andrew].S atin 21 Etiology and management of hemorrhage, 298 7 Neonatal resuscitation, 104 Rosie Burton and Michael A.B elfort Christian Con Yosta nd Ron Bloom 22 Severe acute asthma, 312 8 Airway management in critical illness, 121 WilliamH . Barthand Theresa L. Stewart Janice E. Whitty 23 Systemici nflammatoryr esponse syndrome and acute 9 Vascular access, 146 respiratory distress syndrome, 329 Gayle Olson and Aristides Koutrouvelis Brian A.M ason V Contents 24 Pulmonary edema, 346 37 Thermal and electrical injury, 506 WilliamC .M abie Cornelia R. Graves 25 The acute abdomen, 354 38 Overdose, poisoning, and envenomation,5 12 Howard T. Sharp AlfredoF . Gei and VictorR . Surfrez 26 Acute pancreatitis, 361 39 Hypovolemic and cardiac shock, 553 Karen A.Z empolich Scott Roberts 27 Acute renal failure, 372 40 Septic shock, 562 Shad H. Deeringand Gail L. Seiken Michael R. Leonardi and Bernard Gonik 28 Acute fatty liver of pregnancy, 380 41 Anaphylactic shock, 581 T. Flint Porter Donna Diwn-Townson 29 Sickle-cell crisis, 386 Lisa E. Moore and James N.M artin, Jr V. Special considerations 30 Disseminated intravascular coagulopathy, 394 Luis Diego Pacheco, James W. VanH ook,a nd AlfredoF . Gei 42 Fetal considerationsi n the critically ill gravida, 593 JeffreyP . Phelan, Cortney Kirkendall,a nd Shailen S. Shah 31 Thrombotic microangiopathies, 408 Christopher A. Sullivan and James N.M artin,Jr 43 Fetal effects of drugs commonly used in critical care, 612 Jerome Yankowitz 32 Endocrine emergencies,4 20 Carey L. Winklera nd Lowell E . Davis 44 Anesthesia for the critically ill parturient with cardiac disease and pregnancy-inducedh ypertension, 620 33 Complications of preeclampsia, 436 Rakesh B. Vadhera G a yA .D ildy I11 45 The organ transplant obstetricp atient, 638 34 Anaphylactoid syndrome of pregnancy (amniotic fluid James R. Scott embolism),4 63 G a yA .D ildy I11 and Steven L. Clark 46 Ethics in the obstetricc ritical care setting, 646 Fidelma B. Rigby 35 Systemicl upus erythematosus and the antiphospholipid syndrode, 472 Appendix 1: Physiologic tables and formulas, 666 T.F lint Porter and D. Ware Branch Appendix 2: Drugs, devices, and fluid therapy, 674 36 Trauma in pregnancy, 484 James W. VanH ook, AlfredoF . Gei, and Luis Diego Pacheco Index, 681 vi Preface The 4th edition of Critical Care Obstetrics embodies the contin- monologists, cardiologists, and other members of the multi- uing accumulation of a rapidly expanding mass of knowl- disciplinary team caring for the critically ill obstetric patient. edge, designed to assist clinicians caring for seriously ill Chapters from the 3rd edition have been extensively revised gravidas. Around the time that the 1st edition of this book was for the 4th edition and new chapters have been added to cover published, obstetric critical care units were being established topics concerning maternal morbidity trends, the organiza- around the country. Countless patient admissions to the tion of an obstetric critical care unit, neonatal resuscitation, ”OB/GYN Intensive Care Unit“ at the University of Southern noninvasive monitoring techniques, pulmonary edema, the California Los Angeles County Woman’s Hospital Medical acute abdomen, anesthesia considerations, the organ trans- Center, the ’Yellow Room” at Baylor’s Jefferson Davis plant patient, and ethical considerations of the critically ill Hospital, and to similar facilities provided the clinical ex- pregnant woman. The 1st edition, published in 1987, con- perience for maternal-fetal medicine subspecialistsi nterested tained 28 chapters; since then, this textbook has evolved into in critical care to primarily manage pregnant patients of the the current edition containing4 6 chapters. highest acuity. With medical technology advancing at a mete- Certainly, the greatest strength of this book is its diverse oric pace, the era of one physician “doing it all” has long group of authors; we sincerely thank everyone who con- passed and is indeed an antiquated concept. The current tributed their time and expertise. We gratefully acknowledge American medical s stem is not structured to support a dedi- Natalie George for meticulously reviewing the references. Y cated obstetric critical care unit in most hospitals, even in Finally, we are grateful to the staff at Blackwell Publishing, tertiary referral centers. This evolution in medicine does not especially Julia Casson and Laura DeYoung, for their portend the demise of the discipline of critical care obstetrics, ongoing support of this book. but rather, further necessitates specialists in obstetrics who can provide complementary knowledge to the nonobstetri- GAD, MAB, GRS, JPP, GDVH, SLC cian. Thus, the purpose of this book is to assist OB/GYN and May 2003 MFM clinicians in working integrally with intensivists, pul- vii Dedications To my parents, Gary and Barbara Dildy, who have provided Community Hospital, Beverly Hospital, Garfield Medical ceaseless support and encouragement Center, and Arcadia Methodist Hospital for their untiring Gary A.D ildy III dedication to the health and safety of pregnant women and To my wife, Dr Joanne Belfort, and my children Sarah and Ben their unborn children and for sharing their insights into the Michael A. Belfort science and art of medicine To my wife, Yomna Tarek Monla, and daughters Lynnie and ]@ey P. Phelan Mia To my wife, Barbara Lynn Hankins George R. Saade Gary D.V .H ankins To all the trench physicians and nurses throughout the United To my parents, Dave and Louise Clark States and the world and, especially, at Citrus Valley Medical Steven L. Clark Center, Pomona Valley Hospital Medical Center, San Antonio viii
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