TY - JOUR
T1 - The safety and utility of pulmonary artery catheterization in severe preeclampsia and eclampsia
AU - Gilbert, William M.
AU - Towner, Dena R.
AU - Field, Nancy T
AU - Anthony, John
PY - 2000
Y1 - 2000
N2 - OBJECTIVE: The objective of this research was to study the safety and utility of pulmonary artery catheterization in the management of severe preeclampsia and eclampsia. STUDY DESIGN: In a retrospective chart review from January 1, 1995, through December 31, 1997, a total of 115 patients admitted to the obstetric intensive care unit at Groote Schuur Hospital were found to have required placement of a pulmonary artery catheter. From this population 100 maternal charts were examined for medical and pregnancy history, including indication for pulmonary artery catheter placement, hemodynamic readings, complications, and subsequent management. RESULTS: The initial indications for pulmonary artery catheter placement in cases of severe preeclampsia or eclampsia were renal failure in 53 cases (53%), pulmonary edema in 30 (30%), and eclampsia in 17 (17%). Subjective evaluation demonstrated that the pulmonary artery catheter was helpful in determining management in 93 cases (93%). There was a 4.0% complication rate, which included three venous thromboses and one case of cellulitis. Eleven patients required dialysis, and 3 women died. The mean (±SE) duration of catheter placement was 2.1 ± 0.1 days and the mean (±SE) intensive care unit and hospital stays were 3.4 ± 0.2 days and 11.4 ± 0.8 days, respectively. The pulmonary artery catheter measurements of pulmonary artery wedge pressure and central venous pressure were increased in the cases of pulmonary edema (21.0 ± 2.0 mm Hg and 9.6 ± 1.2 mm Hg, respectively) but were normal in the cases of renal failure and eclampsia. CONCLUSION: Despite significant maternal morbidity and mortality, pulmonary artery catheter use in cases of severe preeclampsia or eclampsia was subjectively beneficial in 93 of 100 cases (93%), with an acceptable complication rate (4.0%).
AB - OBJECTIVE: The objective of this research was to study the safety and utility of pulmonary artery catheterization in the management of severe preeclampsia and eclampsia. STUDY DESIGN: In a retrospective chart review from January 1, 1995, through December 31, 1997, a total of 115 patients admitted to the obstetric intensive care unit at Groote Schuur Hospital were found to have required placement of a pulmonary artery catheter. From this population 100 maternal charts were examined for medical and pregnancy history, including indication for pulmonary artery catheter placement, hemodynamic readings, complications, and subsequent management. RESULTS: The initial indications for pulmonary artery catheter placement in cases of severe preeclampsia or eclampsia were renal failure in 53 cases (53%), pulmonary edema in 30 (30%), and eclampsia in 17 (17%). Subjective evaluation demonstrated that the pulmonary artery catheter was helpful in determining management in 93 cases (93%). There was a 4.0% complication rate, which included three venous thromboses and one case of cellulitis. Eleven patients required dialysis, and 3 women died. The mean (±SE) duration of catheter placement was 2.1 ± 0.1 days and the mean (±SE) intensive care unit and hospital stays were 3.4 ± 0.2 days and 11.4 ± 0.8 days, respectively. The pulmonary artery catheter measurements of pulmonary artery wedge pressure and central venous pressure were increased in the cases of pulmonary edema (21.0 ± 2.0 mm Hg and 9.6 ± 1.2 mm Hg, respectively) but were normal in the cases of renal failure and eclampsia. CONCLUSION: Despite significant maternal morbidity and mortality, pulmonary artery catheter use in cases of severe preeclampsia or eclampsia was subjectively beneficial in 93 of 100 cases (93%), with an acceptable complication rate (4.0%).
KW - Eclampsia
KW - Preeclampsia
KW - Pulmonary artery catheter
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U2 - 10.1067/mob.2000.106179
DO - 10.1067/mob.2000.106179
M3 - Article
C2 - 10871455
AN - SCOPUS:0033920767
VL - 182
SP - 1397
EP - 1403
JO - American Journal of Obstetrics and Gynecology
JF - American Journal of Obstetrics and Gynecology
SN - 0002-9378
IS - 6
ER -