Please use this identifier to cite or link to this item: http://docs.prosentient.com.au/prosentientjspui/handle/1/11284
Title: Survival after an amniotic fluid embolism following the use of sodium bicarbonate.
Authors: Evans, Sorcha
Brown, Brigid
Mathieson, Matthew
Tay, Stan
Affiliation: Department of Anaesthesia, Townsville Hospital, Douglas, Queensland, Australia..
Department of Anaesthesia, Royal Darwin Hospital, Tiwi, Northern Territory, Australia..
Department of Anaesthesia, Royal Darwin Hospital, Tiwi, Northern Territory, Australia..
Department of Anaesthesia, Royal Darwin Hospital, Tiwi, Northern Territory, Australia..
Issue Date: 30-May-2014
Citation: BMJ case reports 2014-05-30; 2014
Abstract: Amniotic fluid embolism (AFE) is a rare and potentially fatal complication of pregnancy. In this case report, we highlight the successful use of sodium bicarbonate in a patient with an AFE. We present a case of a 38-year-old mother admitted for an elective caesarean section. Following the delivery of her baby, the mother suffered a cardiac arrest. Following a protracted resuscitation, transoesophageal echocardiography demonstrated evidence of acute pulmonary hypertension, with an empty left ventricle and an over-distended right ventricle. In view of these findings and no improvement noted from on-going resuscitation, sodium bicarbonate was infused as a pulmonary vasodilator. Almost instantaneous return of spontaneous circulation was noted, with normalisation of cardiac parameters. We propose that in patients suspected with AFE and who have been unresponsive to advance cardiac life support measures, and where right ventricular failure is present with acidosis and/or hypercarbia, the use of sodium bicarbonate should be considered.
URI: http://docs.prosentient.com.au/prosentientjspui/handle/1/11284
DOI: 10.1136/bcr-2014-204672
Type: Journal Article
Subjects: Adult
Embolism, Amniotic Fluid
Female
Heart Arrest
Humans
Hypertension, Pulmonary
Pregnancy
Sodium Bicarbonate
Vasodilator Agents
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