A Case of Successful Thromboelastographic Guided Resuscitation after Postpartum Hemorrhage and Cardiac Arrest

Amniotic fluid embolism (AFE) is an unusual cause of life threatening peri partum hemorrhage (PPH). AFE resuscitation is often associated with renal and respiratory insufficiency, and a coagulopathy similar to disseminated intravascular coagulation (DIC). Resuscitation requires immediate recognition...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:The Journal of extra-corporeal technology 2016-12, Vol.48 (4), p.194-197
Hauptverfasser: Hurwich, M, Zimmer, D, Guerra, E, Evans, E, Shire, T, Abernathy, M, Shreve, J T, Kolettis, G R, McCurdy, M T, Castellino, F J, Walsh, M
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page 197
container_issue 4
container_start_page 194
container_title The Journal of extra-corporeal technology
container_volume 48
creator Hurwich, M
Zimmer, D
Guerra, E
Evans, E
Shire, T
Abernathy, M
Shreve, J T
Kolettis, G R
McCurdy, M T
Castellino, F J
Walsh, M
description Amniotic fluid embolism (AFE) is an unusual cause of life threatening peri partum hemorrhage (PPH). AFE resuscitation is often associated with renal and respiratory insufficiency, and a coagulopathy similar to disseminated intravascular coagulation (DIC). Resuscitation requires immediate recognition and limited use of crystalloid. We present a case of PPH caused by AFE with resultant cardiac arrest, renal and respiratory failure, and DIC-like coagulopathy, whose successful resuscitation was guided by perfusionist-directed serial thromboelastography (TEG). Viscoelastic tests (VET)s, including the TEG and rotational thromboelastometry (ROTEM), may provide more individualized blood component therapy (BCT) in the treatment of severe PPH associated with AFE as has been previously noted with trauma resuscitation in the literature. However, VET's efficacy is often limited by a lack of standardization, quality assurance norms, and consistent operator proficiency. We suggest that there may be a role for perfusionsts adept at utilizing TEG in the optimization of BCT and adjunctive hemostatic agents in severely hemorrhagic patients. This patient's successful resuscitation demonstrates the importance of resuscitation guided by the perfusionist or other medical professionals with expertise in TEG guided resuscitation and how the administration of specific blood products and hemostatic agents guided by the TEG can help optimize patient outcomes in comparison to traditional 1:1:1 packed red blood cells (PRBC) /fresh frozen plasma (FFP) /platelets ratios given to severely hemorrhaging patients.
doi_str_mv 10.1051/ject/201648194
format Article
fullrecord <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5153306</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1851298552</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3054-b68e4be0cb4a1cee9fd05a8b5c10bcd2c2c6d0ed1ecea99bf43b1b8583013bb63</originalsourceid><addsrcrecordid>eNpVkU1r3DAQhkVoSbZprz0WHXtxMpIsV7oUliVNCoGENj0LfYx3FWxrK8mB_vt6SbqkpznMO8-88BDykcEFA8kuH9HXSw6saxXT7QlZcd3pRukO3pAVAOfNElNn5F0pjwAdA8FOyRn_onXLO1iRcU03tiBNPf05e4-l9PNAH3Y5jS7hYEtN22z3u-jp9RwDBvoDy1x8rLbGNFHbV8z0PpW6t7nOI73BMeW8s1ukdgoLPIdoPV3njKW-J297OxT88DLPya9vVw-bm-b27vr7Zn3beAGybVynsHUI3rWWeUTdB5BWOekZOB-4574LgIGhR6u161vhmFNSCWDCuU6ck6_P3P3sRgwep5rtYPY5jjb_MclG8_9mijuzTU9GMikEHACfXwA5_Z6X5maMxeMw2AnTXAxTknGtpORL9OI56nMqJWN_fMPAHByZgyNzdLQcfHpd7hj_J0X8BeSckXk</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1851298552</pqid></control><display><type>article</type><title>A Case of Successful Thromboelastographic Guided Resuscitation after Postpartum Hemorrhage and Cardiac Arrest</title><source>MEDLINE</source><source>EZB-FREE-00999 freely available EZB journals</source><source>PubMed Central</source><creator>Hurwich, M ; Zimmer, D ; Guerra, E ; Evans, E ; Shire, T ; Abernathy, M ; Shreve, J T ; Kolettis, G R ; McCurdy, M T ; Castellino, F J ; Walsh, M</creator><creatorcontrib>Hurwich, M ; Zimmer, D ; Guerra, E ; Evans, E ; Shire, T ; Abernathy, M ; Shreve, J T ; Kolettis, G R ; McCurdy, M T ; Castellino, F J ; Walsh, M</creatorcontrib><description>Amniotic fluid embolism (AFE) is an unusual cause of life threatening peri partum hemorrhage (PPH). AFE resuscitation is often associated with renal and respiratory insufficiency, and a coagulopathy similar to disseminated intravascular coagulation (DIC). Resuscitation requires immediate recognition and limited use of crystalloid. We present a case of PPH caused by AFE with resultant cardiac arrest, renal and respiratory failure, and DIC-like coagulopathy, whose successful resuscitation was guided by perfusionist-directed serial thromboelastography (TEG). Viscoelastic tests (VET)s, including the TEG and rotational thromboelastometry (ROTEM), may provide more individualized blood component therapy (BCT) in the treatment of severe PPH associated with AFE as has been previously noted with trauma resuscitation in the literature. However, VET's efficacy is often limited by a lack of standardization, quality assurance norms, and consistent operator proficiency. We suggest that there may be a role for perfusionsts adept at utilizing TEG in the optimization of BCT and adjunctive hemostatic agents in severely hemorrhagic patients. This patient's successful resuscitation demonstrates the importance of resuscitation guided by the perfusionist or other medical professionals with expertise in TEG guided resuscitation and how the administration of specific blood products and hemostatic agents guided by the TEG can help optimize patient outcomes in comparison to traditional 1:1:1 packed red blood cells (PRBC) /fresh frozen plasma (FFP) /platelets ratios given to severely hemorrhaging patients.</description><identifier>ISSN: 0022-1058</identifier><identifier>EISSN: 2969-8960</identifier><identifier>DOI: 10.1051/ject/201648194</identifier><identifier>PMID: 27994260</identifier><language>eng</language><publisher>United States: American Society of ExtraCorporeal Technology</publisher><subject>Adult ; Blood Transfusion - methods ; Cardiopulmonary Resuscitation - methods ; Case Reports ; Combined Modality Therapy - methods ; Female ; Heart Arrest - blood ; Heart Arrest - diagnosis ; Heart Arrest - prevention &amp; control ; Humans ; Postpartum Hemorrhage - blood ; Postpartum Hemorrhage - therapy ; Thrombelastography - methods ; Treatment Outcome</subject><ispartof>The Journal of extra-corporeal technology, 2016-12, Vol.48 (4), p.194-197</ispartof><rights>Copyright 2016 AMSECT 2016</rights><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3054-b68e4be0cb4a1cee9fd05a8b5c10bcd2c2c6d0ed1ecea99bf43b1b8583013bb63</citedby><cites>FETCH-LOGICAL-c3054-b68e4be0cb4a1cee9fd05a8b5c10bcd2c2c6d0ed1ecea99bf43b1b8583013bb63</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5153306/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5153306/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27994260$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hurwich, M</creatorcontrib><creatorcontrib>Zimmer, D</creatorcontrib><creatorcontrib>Guerra, E</creatorcontrib><creatorcontrib>Evans, E</creatorcontrib><creatorcontrib>Shire, T</creatorcontrib><creatorcontrib>Abernathy, M</creatorcontrib><creatorcontrib>Shreve, J T</creatorcontrib><creatorcontrib>Kolettis, G R</creatorcontrib><creatorcontrib>McCurdy, M T</creatorcontrib><creatorcontrib>Castellino, F J</creatorcontrib><creatorcontrib>Walsh, M</creatorcontrib><title>A Case of Successful Thromboelastographic Guided Resuscitation after Postpartum Hemorrhage and Cardiac Arrest</title><title>The Journal of extra-corporeal technology</title><addtitle>J Extra Corpor Technol</addtitle><description>Amniotic fluid embolism (AFE) is an unusual cause of life threatening peri partum hemorrhage (PPH). AFE resuscitation is often associated with renal and respiratory insufficiency, and a coagulopathy similar to disseminated intravascular coagulation (DIC). Resuscitation requires immediate recognition and limited use of crystalloid. We present a case of PPH caused by AFE with resultant cardiac arrest, renal and respiratory failure, and DIC-like coagulopathy, whose successful resuscitation was guided by perfusionist-directed serial thromboelastography (TEG). Viscoelastic tests (VET)s, including the TEG and rotational thromboelastometry (ROTEM), may provide more individualized blood component therapy (BCT) in the treatment of severe PPH associated with AFE as has been previously noted with trauma resuscitation in the literature. However, VET's efficacy is often limited by a lack of standardization, quality assurance norms, and consistent operator proficiency. We suggest that there may be a role for perfusionsts adept at utilizing TEG in the optimization of BCT and adjunctive hemostatic agents in severely hemorrhagic patients. This patient's successful resuscitation demonstrates the importance of resuscitation guided by the perfusionist or other medical professionals with expertise in TEG guided resuscitation and how the administration of specific blood products and hemostatic agents guided by the TEG can help optimize patient outcomes in comparison to traditional 1:1:1 packed red blood cells (PRBC) /fresh frozen plasma (FFP) /platelets ratios given to severely hemorrhaging patients.</description><subject>Adult</subject><subject>Blood Transfusion - methods</subject><subject>Cardiopulmonary Resuscitation - methods</subject><subject>Case Reports</subject><subject>Combined Modality Therapy - methods</subject><subject>Female</subject><subject>Heart Arrest - blood</subject><subject>Heart Arrest - diagnosis</subject><subject>Heart Arrest - prevention &amp; control</subject><subject>Humans</subject><subject>Postpartum Hemorrhage - blood</subject><subject>Postpartum Hemorrhage - therapy</subject><subject>Thrombelastography - methods</subject><subject>Treatment Outcome</subject><issn>0022-1058</issn><issn>2969-8960</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpVkU1r3DAQhkVoSbZprz0WHXtxMpIsV7oUliVNCoGENj0LfYx3FWxrK8mB_vt6SbqkpznMO8-88BDykcEFA8kuH9HXSw6saxXT7QlZcd3pRukO3pAVAOfNElNn5F0pjwAdA8FOyRn_onXLO1iRcU03tiBNPf05e4-l9PNAH3Y5jS7hYEtN22z3u-jp9RwDBvoDy1x8rLbGNFHbV8z0PpW6t7nOI73BMeW8s1ukdgoLPIdoPV3njKW-J297OxT88DLPya9vVw-bm-b27vr7Zn3beAGybVynsHUI3rWWeUTdB5BWOekZOB-4574LgIGhR6u161vhmFNSCWDCuU6ck6_P3P3sRgwep5rtYPY5jjb_MclG8_9mijuzTU9GMikEHACfXwA5_Z6X5maMxeMw2AnTXAxTknGtpORL9OI56nMqJWN_fMPAHByZgyNzdLQcfHpd7hj_J0X8BeSckXk</recordid><startdate>20161201</startdate><enddate>20161201</enddate><creator>Hurwich, M</creator><creator>Zimmer, D</creator><creator>Guerra, E</creator><creator>Evans, E</creator><creator>Shire, T</creator><creator>Abernathy, M</creator><creator>Shreve, J T</creator><creator>Kolettis, G R</creator><creator>McCurdy, M T</creator><creator>Castellino, F J</creator><creator>Walsh, M</creator><general>American Society of ExtraCorporeal Technology</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20161201</creationdate><title>A Case of Successful Thromboelastographic Guided Resuscitation after Postpartum Hemorrhage and Cardiac Arrest</title><author>Hurwich, M ; Zimmer, D ; Guerra, E ; Evans, E ; Shire, T ; Abernathy, M ; Shreve, J T ; Kolettis, G R ; McCurdy, M T ; Castellino, F J ; Walsh, M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3054-b68e4be0cb4a1cee9fd05a8b5c10bcd2c2c6d0ed1ecea99bf43b1b8583013bb63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adult</topic><topic>Blood Transfusion - methods</topic><topic>Cardiopulmonary Resuscitation - methods</topic><topic>Case Reports</topic><topic>Combined Modality Therapy - methods</topic><topic>Female</topic><topic>Heart Arrest - blood</topic><topic>Heart Arrest - diagnosis</topic><topic>Heart Arrest - prevention &amp; control</topic><topic>Humans</topic><topic>Postpartum Hemorrhage - blood</topic><topic>Postpartum Hemorrhage - therapy</topic><topic>Thrombelastography - methods</topic><topic>Treatment Outcome</topic><toplevel>online_resources</toplevel><creatorcontrib>Hurwich, M</creatorcontrib><creatorcontrib>Zimmer, D</creatorcontrib><creatorcontrib>Guerra, E</creatorcontrib><creatorcontrib>Evans, E</creatorcontrib><creatorcontrib>Shire, T</creatorcontrib><creatorcontrib>Abernathy, M</creatorcontrib><creatorcontrib>Shreve, J T</creatorcontrib><creatorcontrib>Kolettis, G R</creatorcontrib><creatorcontrib>McCurdy, M T</creatorcontrib><creatorcontrib>Castellino, F J</creatorcontrib><creatorcontrib>Walsh, M</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>The Journal of extra-corporeal technology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hurwich, M</au><au>Zimmer, D</au><au>Guerra, E</au><au>Evans, E</au><au>Shire, T</au><au>Abernathy, M</au><au>Shreve, J T</au><au>Kolettis, G R</au><au>McCurdy, M T</au><au>Castellino, F J</au><au>Walsh, M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A Case of Successful Thromboelastographic Guided Resuscitation after Postpartum Hemorrhage and Cardiac Arrest</atitle><jtitle>The Journal of extra-corporeal technology</jtitle><addtitle>J Extra Corpor Technol</addtitle><date>2016-12-01</date><risdate>2016</risdate><volume>48</volume><issue>4</issue><spage>194</spage><epage>197</epage><pages>194-197</pages><issn>0022-1058</issn><eissn>2969-8960</eissn><abstract>Amniotic fluid embolism (AFE) is an unusual cause of life threatening peri partum hemorrhage (PPH). AFE resuscitation is often associated with renal and respiratory insufficiency, and a coagulopathy similar to disseminated intravascular coagulation (DIC). Resuscitation requires immediate recognition and limited use of crystalloid. We present a case of PPH caused by AFE with resultant cardiac arrest, renal and respiratory failure, and DIC-like coagulopathy, whose successful resuscitation was guided by perfusionist-directed serial thromboelastography (TEG). Viscoelastic tests (VET)s, including the TEG and rotational thromboelastometry (ROTEM), may provide more individualized blood component therapy (BCT) in the treatment of severe PPH associated with AFE as has been previously noted with trauma resuscitation in the literature. However, VET's efficacy is often limited by a lack of standardization, quality assurance norms, and consistent operator proficiency. We suggest that there may be a role for perfusionsts adept at utilizing TEG in the optimization of BCT and adjunctive hemostatic agents in severely hemorrhagic patients. This patient's successful resuscitation demonstrates the importance of resuscitation guided by the perfusionist or other medical professionals with expertise in TEG guided resuscitation and how the administration of specific blood products and hemostatic agents guided by the TEG can help optimize patient outcomes in comparison to traditional 1:1:1 packed red blood cells (PRBC) /fresh frozen plasma (FFP) /platelets ratios given to severely hemorrhaging patients.</abstract><cop>United States</cop><pub>American Society of ExtraCorporeal Technology</pub><pmid>27994260</pmid><doi>10.1051/ject/201648194</doi><tpages>4</tpages><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 0022-1058
ispartof The Journal of extra-corporeal technology, 2016-12, Vol.48 (4), p.194-197
issn 0022-1058
2969-8960
language eng
recordid cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5153306
source MEDLINE; EZB-FREE-00999 freely available EZB journals; PubMed Central
subjects Adult
Blood Transfusion - methods
Cardiopulmonary Resuscitation - methods
Case Reports
Combined Modality Therapy - methods
Female
Heart Arrest - blood
Heart Arrest - diagnosis
Heart Arrest - prevention & control
Humans
Postpartum Hemorrhage - blood
Postpartum Hemorrhage - therapy
Thrombelastography - methods
Treatment Outcome
title A Case of Successful Thromboelastographic Guided Resuscitation after Postpartum Hemorrhage and Cardiac Arrest
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-24T18%3A32%3A42IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=A%20Case%20of%20Successful%20Thromboelastographic%20Guided%20Resuscitation%20after%20Postpartum%20Hemorrhage%20and%20Cardiac%20Arrest&rft.jtitle=The%20Journal%20of%20extra-corporeal%20technology&rft.au=Hurwich,%20M&rft.date=2016-12-01&rft.volume=48&rft.issue=4&rft.spage=194&rft.epage=197&rft.pages=194-197&rft.issn=0022-1058&rft.eissn=2969-8960&rft_id=info:doi/10.1051/ject/201648194&rft_dat=%3Cproquest_pubme%3E1851298552%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1851298552&rft_id=info:pmid/27994260&rfr_iscdi=true