Document Detail


Beneficial outcome after prostaglandin-induced post-partum cardiac arrest using levosimendan and extracorporeal membrane oxygenation.
MedLine Citation:
PMID:  16987377     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Administration of high doses of prostaglandins is a frequently performed and effective method for the treatment of atonic uterine haemorrhage in order to increase uterine muscle tone. Rarely, however, these drugs may cause life-threatening complications including bronchospasm, acute pulmonary oedema and myocardial infarction caused by coronary spasms. METHODS: We discuss the management of a patient suffering post-partum atonic uterine bleeding, catecholamine-resistant cardiac arrest and fulminant pulmonary failure due to deleterious side-effects of treatment with prostaglandins. RESULTS: During therapy resistant cardiopulmonary resuscitation, the addition of levosimendan to standard medications resulted in a prompt stabilization of haemodynamics. Subsequent treatment of pulmonary failure was successfully managed with ECMO. CONCLUSION: Although levosimendan is not approved for pharmacological treatment of cardiopulmonary arrest, the beneficial effects in this patient suggest an important role of calcium sensitization and vasodilation during prostaglandin-induced cardiac arrest.
Authors:
J J Krumnikl; W G Toller; G Prenner; H Metzler
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Acta anaesthesiologica Scandinavica     Volume:  50     ISSN:  0001-5172     ISO Abbreviation:  Acta Anaesthesiol Scand     Publication Date:  2006 Jul 
Date Detail:
Created Date:  2006-09-21     Completed Date:  2006-10-12     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0370270     Medline TA:  Acta Anaesthesiol Scand     Country:  England    
Other Details:
Languages:  eng     Pagination:  768-70     Citation Subset:  IM    
Affiliation:
Department of Anaesthesiology and Intensive Care Medicine, Medical University of Graz, Graz, Austria. jakub.krumnikl@meduni-graz.at
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MeSH Terms
Descriptor/Qualifier:
Adult
Cardiotonic Agents / therapeutic use*
Catecholamines / therapeutic use
Cesarean Section
Drug Resistance
Extracorporeal Membrane Oxygenation*
Female
Heart Arrest / chemically induced*,  drug therapy*
Hemodynamics / drug effects
Humans
Hydrazones / therapeutic use*
Lung Diseases / complications,  drug therapy
Postpartum Hemorrhage / drug therapy
Pregnancy
Prostaglandins / adverse effects*
Pyridazines / therapeutic use*
Treatment Outcome
Uterine Diseases / drug therapy
Chemical
Reg. No./Substance:
0/Cardiotonic Agents; 0/Catecholamines; 0/Hydrazones; 0/Prostaglandins; 0/Pyridazines; 131741-08-7/simendan

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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