Book of PDFs-Critical Care in Pregnancy

Critical Care in Pregnancy

Pdf Summary

Critical care in pregnancy is a topic of concern due to the unique physiological changes that occur during this time. Statistics show that pregnant and post-partum women account for a percentage of intensive care unit admissions, with the mortality rate being higher in developing countries. Pregnancy-related complications that can lead to critical care needs include preeclampsia/eclampsia, hemorrhage, acute respiratory distress syndrome (ARDS), and venous air embolism, among others. Various conditions can worsen during pregnancy, such as cardiac disease, pulmonary hypertension, and diabetes.<br /><br />In terms of respiratory physiology, pregnancy leads to an increase in minute ventilation, tidal volume, and respiratory rate. The upper respiratory tract undergoes changes such as hyperemia and edema of the airway mucosa, increased secretions, and conditions like nasal polyps and allergic rhinitis. Gas exchange is slightly altered, with a compensatory respiratory alkalosis and increased oxygen consumption.<br /><br />Cardiovascular physiology is also affected during pregnancy, with increased cardiac output, heart rate, and stroke volume. Systemic vascular resistance and blood pressure decrease, leading to the possibility of postural hypotension. There is also an increase in total blood volume, plasma volume, and red blood cell volume.<br /><br />Other physiological changes include a hypercoagulable state, renal and gastrointestinal changes, and dyspnea. The FDA has a drug classification system for pregnancy and lactation, allowing doctors to better understand the safety and risk of medication use in pregnant and lactating women.<br /><br />During critical care management, hemodynamic issues such as high cardiac output and low systemic vascular resistance must be considered. Intubation can be more challenging due to upper airway edema and bleeding, while mechanical ventilation should prioritize low tidal volume and maintain eucapnia. It is important for healthcare professionals to collaborate in decision-making, including pulmonologists, intensivists, obstetricians, neonatologists, and specialty nursing.<br /><br />Overall, understanding the normal physiology of pregnancy and the specific critical care issues that can arise is crucial for providing appropriate and effective care to pregnant patients in the ICU.

Keywords

Critical care in pregnancy

physiological changes

intensive care unit admissions

mortality rate

preeclampsia/eclampsia

respiratory physiology

cardiovascular physiology

hemodynamic issues

mechanical ventilation

collaboration in decision-making