Cover Image

Management of Case of Disseminated Intravascular Coagulation on Prolonged Ventilation

Dinesh kumar K, Chandrasekaran A and Sen .

Abstract


This is a case of 22 weeks primigravida presenting for emergency hysterotomy. She was diagnosed as antepartum eclampsia, grade III abruption with IUD. Case was proceeded under ETGA with controlled ventilation. Intraoperative period was uneventful. Patient not extubated and shifted to PAICU for elective post operative ventilation. Patient diagnosed as HELLP syndrome/Acute kidney injury/DIVC/sepsis. 7 cycles of hemodialysis and 2 cycles of plasmapheresis done. Tracheostomy done and on continuous ventilatory support. Patient treated with magnesium sulphate, higher antibiotics, anti epileptic, diuretics, chest physiotherapy. Renal parameters and coagulation profile return to normal. Tracheostomy tube removed and stoma closed. Patient discharged with stable vitals on 94th POD.

 


Full Text:

PDF

References


Venugopal A. Disseminated intravascular coagulation. Indian J Anaesth 2014;58:603-8

Chesley LC. Disseminated intravascular coagulation. In: Chesley LC, editor. Hypertensive Disorders in Pregnancy. New York : Appleton Century-Crofts, 19781988.

Fiastro JF, Habib MP, Shon BY, Campbell SC (1988) Comparison of standard weaning parameters and the mechanical work of breathing in mechanically ventilated patient. Chest 94:232–238

Fitzgerald, L.M., Weaning the patient from mechanical ventilation.228-234

Kaplan BS, Meyers KE, Schulman SL: The pathogenesis and treatment of hemolytic uremic syndrome. J Am Soc Nephrol 9 : 1126 –1133, 1998.

Siegler R, Oakes R. Hemolytic uremic syndrome; pathogenesis, treatment, and outcome.2005

Chastre J, Fagon JY. Pneumonia in the ventilator-dependent patient. In: Tobin MJ, editor. Principles And practice of mechanical ventilation. New York: McGraw-Hill; 1994. p. 857–890.

Chevret S, Hemmer M, Carlet J, Langer MIncidence and risk factors of pneumonia acquired in intensive care units. European Cooperative Group on Nosocomial Pneumonia. Intensive Care

Med 191993256264 McGrath BA. Management of the day-to-day needs of the patient with a tracheostomy and laryngectomy. In: McGrath B, ed. Comprehensive Tracheostomy Care: The National Tracheostomy Safety Project Manual. Hoboken, NJ: Wiley Blackwell; 2014:chap 5.


Refbacks

  • There are currently no refbacks.


Creative Commons License
This work is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License.

An initiative of The Tamil Nadu Dr M.G.R. Medical University