Obstetrik ve Jinekolojide İnvasiv Hemodinamik Monitorizasyon

Yıl 1997, Cilt: 2 Sayı: 2, 5 - 8, 30.04.1997

Ahmet Erk Nadi Keskin Murat Dikmengil Baki Komsuoğlu

Öz

Obstetrik ve jinekolokideki invasiv hemodinamik monitorizasyon endikasyonları diğer cerrahi ve dahili branştakilerle aynıdır. Monitorizasyon hakkındaki klinik uygulama kesin kriterlere bağlanamaz ve her vaka için ayrı ayrı değerlendirilmelidir. Her hasta invasiv monitorizasyondan fayda görmeyeceğinden uygun hasta seçimi önemlidir. Elde edilen bilgilerden tedavi yöntemlerinin yönlendirilmesi ve değerlendirilmesinde kullanılır. Bu durumda uygun tedavi kritik hastalığın veya kardiyak respiratuvar dekompansasyon sonucunda önemli etkisi olur. Halen jinekoloji ve obstetrikte pulmoner arter katerizasyonunun etkinliği üzerine prospektif randomize bir çalışma mevcut değildir.

Anahtar Kelimeler

Hemodinamik monitörizasyon, obstetrik, jinekoloji

Invasive Hemodynamic Monitoring in Obstetrics and Gynecology

Öz

The indications for invasive hemodynamic monitoring in obstetrics and gynecology are much the same in any other area of medicine and surgery. The clinical decision of whether to employ monitoring cannot be made according to absolute criteria but must me made on individual basis. Proper patient selection is important because not every patient will benefit from invasive monitoring. Also skilled physicians, nurses and support personnel should be available. The information collected can be used to both guide and evaluate therapeutic maneuvers. Proper management in these conditions would have a significant impact on the outcome of a critical illness or on the patients on the verge of cardiac or respiratory decompensation. Currently there is no prospective randomized study about the efficiency of the pulmonary artery catheter in obstetrics and gynecology.

Anahtar Kelimeler

Hemodynamic monitoring, obstetrics, gynecology

Kaynakça

• Swann HJ, Ganz W, Forrster J, Marcus H, Diamond G, Chonette D. Catheterization of the heart in man with use of a flow-directed balloon-tipped catheter. N. Eng. J. Med. 1970;283(9):447-451. Berkowitz RL, Rafferty TD. Pulmonary artery flow-directed catheter use in the obstetric patient. Obstet Gynecol. 1980;55(4):507-11. Cotton DB, Benedetti TJ. Use of the Swan-Ganz catheter in obstetrics and gynecology. Obstet Gynecol. 1980;56(5):641-5.
• Clark SL, Horenstein JM, Phelan JP, Montag TW, Paul RH. Experience with the pulmonary artery catheter in obstetrics and gynecology. Am J Obstet Gynecol. 1985;152(4):374-378.
• Benedetti TJ, Hargrove JC, Rosene KA. Maternal pulmonary edema during premature labor inhibition. Obstet Gynecol. 1982;59(6 Suppl):33S-37S.
• Hankins GD, Wendel GD Jr, Leveno KJ, Stoneham J. Myocardial infarction during pregnancy: a review. Obstet Gynecol. 1985;65(1):139-146.
• Cunningham FG, Leveno KJ, Hankins GD, Whalley PJ. Respiratory insufficiency associated with pyelonephritis during pregnancy. Obstet Gynecol. 1984;63(1):121-125.
• Boothby WM, Sandiford RB. Nomographic Charts for the Calculation of the Metabolic Rate by the Gasometer Method. Boston Med Surg. 1921; 185:337-354. doi:10.1056/NEJM192109221851201
• Rosenthal MH. Intrapartum intensive care management of the cardiac patient. Clin Obstet Gynecol. 1981;24(3):789-807. doi:10.1097/00003081-198109000-00007
• Clark SL, Cotton DB, Lee W, et al. Central hemodynamic assessment of normal term pregnancy. Am J Obstet Gynecol. 1989;161(6 Pt 1):1439-1442. doi:10.1016/0002-9378(89)90900-9
• Lappas DG, Powell WM, Dagget WM. Cardiac dys-function in the postoperative period: pathophysiology, diagnosis and treatment. Anesthesiology. 1977:47;117-137.
• Dolgin M. New York Heart Association. Nomenclature and criteria for diagnosis od diseases of the heart and great vessels. In: Dolgin M. The Criteria Committee of New York Heart Association. 8th ed. Boston:Little Brown; 1979.
• Cotton DB, Gonik B, Dorman KF. Cardiovascular alterations in severe pregnancy-induced hypertension seen with an intravenously given hydralazine bolus. Surg Gynecol Obstet. 1985;161(3):240-244.
• Buchbinder N, Ganz W. Hemodynamic monitoring: invasive techniques. Anesthesiology. 1976;45(2):146-155. doi: 10.1097/00000542-197608000-00005
• Moser KM, Spragg RG. Use of balloon-tipped pulmonary artery catheter in pulmonary disease. Ann Intern Med. 1983.