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Case Report: Perioperative management of a pregnant poly trauma patient for spine fixation surgery.

Vandse R, Cook M, Bergese S - F1000Res (2015)

Bottom Line: Trauma is estimated to complicate approximately one in twelve pregnancies, and is currently a leading non-obstetric cause of maternal death.Pregnant trauma patients requiring non-obstetric surgery pose a number of challenges for anesthesiologists.Here we present the successful perioperative management of a pregnant trauma patient with multiple injuries including occult pneumothorax who underwent T9 to L1 fusion in prone position, and address the pertinent perioperative anesthetic considerations and management.

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesiology, Wexner Medical Center, Ohio State University, Columbus, Ohio, 43210, USA.

ABSTRACT
Trauma is estimated to complicate approximately one in twelve pregnancies, and is currently a leading non-obstetric cause of maternal death. Pregnant trauma patients requiring non-obstetric surgery pose a number of challenges for anesthesiologists. Here we present the successful perioperative management of a pregnant trauma patient with multiple injuries including occult pneumothorax who underwent T9 to L1 fusion in prone position, and address the pertinent perioperative anesthetic considerations and management.

No MeSH data available.


Related in: MedlinePlus

A preoperative chest X-ray showing complete collapse of the left lung.
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f1: A preoperative chest X-ray showing complete collapse of the left lung.

Mentions: This is a case of a previously healthy 32 year old female, who presented while 17 weeks pregnant as a level 2 trauma following a motor vehicle collision. She had sustained multiple injuries including Grade II liver laceration, pelvic fracture, bilateral clavicle fractures, C1 transverse process fracture, T11 vertebral body burst fracture, R rib 1–10 fractures, L 1st and 2nd rib fractures, bilateral small pneumothoraces and right pulmonary contusion. She was moderately built and nourished, was 66 inches tall and weighed 136 pounds. Her vital signs on admission showed: heart rate of 96 beats/minute, respiratory rate of 14–18 breaths/minute, blood pressure of 108/56 mmHg, and O2 saturation of 98% on 2–3 liters of oxygen through nasal cannula. She remained hemodynamically stable throughout and did not show any signs of respiratory distress, although she did have some trouble with coughing and clearing respiratory secretions. A preoperative chest X-ray demonstrated complete collapse of the left lung (Figure 1). The small pneumothorax that was discovered in a computed tomography (CT) of the chest, however, was not apparent in the chest X-ray. After a multidisciplinary discussion, because of the unstable spine fracture, it was decided to perform a posterior T9-L1 fusion under general anesthesia. Her lab values were otherwise normal except for hemoglobin of 9.5 and hematocrit of 27.4.


Case Report: Perioperative management of a pregnant poly trauma patient for spine fixation surgery.

Vandse R, Cook M, Bergese S - F1000Res (2015)

A preoperative chest X-ray showing complete collapse of the left lung.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4536612&req=5

f1: A preoperative chest X-ray showing complete collapse of the left lung.
Mentions: This is a case of a previously healthy 32 year old female, who presented while 17 weeks pregnant as a level 2 trauma following a motor vehicle collision. She had sustained multiple injuries including Grade II liver laceration, pelvic fracture, bilateral clavicle fractures, C1 transverse process fracture, T11 vertebral body burst fracture, R rib 1–10 fractures, L 1st and 2nd rib fractures, bilateral small pneumothoraces and right pulmonary contusion. She was moderately built and nourished, was 66 inches tall and weighed 136 pounds. Her vital signs on admission showed: heart rate of 96 beats/minute, respiratory rate of 14–18 breaths/minute, blood pressure of 108/56 mmHg, and O2 saturation of 98% on 2–3 liters of oxygen through nasal cannula. She remained hemodynamically stable throughout and did not show any signs of respiratory distress, although she did have some trouble with coughing and clearing respiratory secretions. A preoperative chest X-ray demonstrated complete collapse of the left lung (Figure 1). The small pneumothorax that was discovered in a computed tomography (CT) of the chest, however, was not apparent in the chest X-ray. After a multidisciplinary discussion, because of the unstable spine fracture, it was decided to perform a posterior T9-L1 fusion under general anesthesia. Her lab values were otherwise normal except for hemoglobin of 9.5 and hematocrit of 27.4.

Bottom Line: Trauma is estimated to complicate approximately one in twelve pregnancies, and is currently a leading non-obstetric cause of maternal death.Pregnant trauma patients requiring non-obstetric surgery pose a number of challenges for anesthesiologists.Here we present the successful perioperative management of a pregnant trauma patient with multiple injuries including occult pneumothorax who underwent T9 to L1 fusion in prone position, and address the pertinent perioperative anesthetic considerations and management.

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesiology, Wexner Medical Center, Ohio State University, Columbus, Ohio, 43210, USA.

ABSTRACT
Trauma is estimated to complicate approximately one in twelve pregnancies, and is currently a leading non-obstetric cause of maternal death. Pregnant trauma patients requiring non-obstetric surgery pose a number of challenges for anesthesiologists. Here we present the successful perioperative management of a pregnant trauma patient with multiple injuries including occult pneumothorax who underwent T9 to L1 fusion in prone position, and address the pertinent perioperative anesthetic considerations and management.

No MeSH data available.


Related in: MedlinePlus