Acute hypotension associated with intraoperative cell salvage using a leukocyte depletion filter during management of obstetric hemorrhage due to amniotic fluid embolism

William Kirke Rogers; Sarah A Wernimont; Girish C Kumar; Eliza Bennett; David H Chestnut

doi:10.1213/ANE.0b013e3182938079

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Acute hypotension associated with intraoperative cell salvage using a leukocyte depletion filter during management of obstetric hemorrhage due to amniotic fluid embolism

Journal article

Peer reviewed

Acute hypotension associated with intraoperative cell salvage using a leukocyte depletion filter during management of obstetric hemorrhage due to amniotic fluid embolism

William Kirke Rogers, Sarah A Wernimont, Girish C Kumar, Eliza Bennett and David H Chestnut

Anesthesia and analgesia, Vol.117(2), pp.449-452

08/2013

DOI: 10.1213/ANE.0b013e3182938079

PMID: 23749444

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Abstract

Amniotic fluid embolism (AFE) is a rare but catastrophic obstetric complication that can lead to profound coagulopathy and hemorrhage. The role of cell salvage and recombinant human Factor VIIa (rFVIIa) administration in such cases remains unclear. We present a case of AFE and describe our experience with the use of cell salvage and rFVIIa administration during the resuscitation. Cell salvage and transfusion through a leukocyte depletion filter was attempted after the diagnosis of AFE was made, but the attempted transfusion was immediately followed by hypotension and a worsening of hemodynamics. rFVIIa, on the contrary, was used with clinical improvement in coagulopathy and without apparent adverse thrombotic effect.

Recombinant Proteins - therapeutic use

Cesarean Section - adverse effects

Postpartum Hemorrhage - diagnosis

Humans

Operative Blood Salvage - adverse effects

Postpartum Hemorrhage - etiology

Factor VIIa - therapeutic use

Leukocyte Reduction Procedures - instrumentation

Hypotension - drug therapy

Blood Transfusion, Autologous - instrumentation

Hypotension - physiopathology

Adult

Female

Hypotension - etiology

Blood Pressure - drug effects

Embolism, Amniotic Fluid - therapy

Vasoconstrictor Agents - therapeutic use

Acute Disease

Blood Transfusion, Autologous - adverse effects

Postpartum Hemorrhage - therapy

Embolism, Amniotic Fluid - diagnosis

Operative Blood Salvage - instrumentation

Treatment Outcome

Hypotension - diagnosis

Embolism, Amniotic Fluid - etiology

Pregnancy

Coagulants - therapeutic use

Details

Title: Subtitle: Acute hypotension associated with intraoperative cell salvage using a leukocyte depletion filter during management of obstetric hemorrhage due to amniotic fluid embolism
Creators: William Kirke Rogers - Department of Anesthesiology, University of Wisconsin School of Medicine and Public Health, 600 Highland Ave., B6/319 CSC, Madison, WI 53792-3272, USA. wrogers@uwhealth.org
Sarah A Wernimont
Girish C Kumar
Eliza Bennett
David H Chestnut
Resource Type: Journal article
Publication Details: Anesthesia and analgesia, Vol.117(2), pp.449-452
DOI: 10.1213/ANE.0b013e3182938079
PMID: 23749444
ISSN: 0003-2999
eISSN: 1526-7598
Language: English
Date published: 08/2013
Academic Unit: Anesthesia
Record Identifier: 9984083282702771

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