000			02813nam a22002297a 4500
005			20240814100201.0
008			240814b ph ||||| |||| 00| 0 eng d
040			_cOCT
100			_aSundin, Courtney Stanley
240			_aThe american journal of maternal / child nursing / _hJanuary/February 2024
245			_aExtracorporeal cardiopulmonary resuscitation for amniotic fluid embolism : _bReview and case report / _cCourtney Stanley Sundin, Laura Gomez, and Brian Chapman
300			_aVol 49 (1) pages 29-37 : _billustrations ; _c26 cm
500			_aAbstract Amniotic fluid embolism (AFE) is a rare, sudden, and catastrophic complication of pregnancy that can result in cardiopulmonary arrest, potentially leading to death. The pathophysiology of an AFE includes an inflammatory and coagulopathic response due to fetal materials entering maternal circulation with the hallmark triad of symptoms: acute respiratory distress, cardiovascular collapse, and coagulopathy. Management of AFE should include high-quality cardiopulmonary resuscitation, immediate delivery of the fetus if applicable, early intubation to provide adequate oxygenation and ventilation, fluid volume resuscitation, and ongoing evaluation of coagulopathy. Priorities include thromoboelastog-raphy interpretation if available, control of hemorrhage and coagulopa-thy with blood component therapy, and cardiovascular support through inotropes and vasopressor administration. More recent approaches include implementing the A-OK (atropine, ondansetron, and ketorolac) protocol for suspected AFE protocol, extracorporeal cardiopulmonary resuscitation (ECPR), and extracorporeal membrane oxygenation (ECMO) therapies to increase survival and decrease complications. Venoarte-rial ECMO is the highest form of life support that provides support in patients with pulmonary and cardiac failure. ECPR is the application of Venoarterial ECMO during cardiopulmonary resuscitation in cases where the cause of arrest is believed to be reversible. Early implementation of ECPR during the acute phase of AFE can provide support for end-organ perfusion in place of the weakened and recovering heart while optimizing oxygenation, making venoarterial ECMO an ideal adjunctive therapy. Because of the rarity of AFE, many obstetrical teams may have limited prior experience in managing these catastrophic cases; however, with ongoing education and simulation, teams can be better prepared in the recognition and management of these life-threatening events.
650			_aAmniotic fluid
650			_aCardiopulmonary resuscitation
650			_aDisseminated intravascular coagulation
650			_aExtracorporeal membrane oxygenation
650			_apregnancy complications
700			_aGomez, Luara
700			_aChapman, Brian
942			_2ddc _cCR _n0
999			_c9689 _d9689