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首页> 外文期刊>The journal of maternal-fetal & neonatal medicine >Impact of nonpneumatic antishock garment in the management of patients with hypoperfusion due to massive postpartum hemorrhage
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Impact of nonpneumatic antishock garment in the management of patients with hypoperfusion due to massive postpartum hemorrhage

机译：非吸油服装在大规模产后出血引起的血液灌注患者管理中的影响

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Objective:The objective of this article was to compare hemodynamic and perfusion parameters as well as the clinical outcomes in critically ill patients with postpartum hemorrhage (PPH) who received treatment with a nonpneumatic antishock garment (NASG) as part of an intervention package, with a group of patients in similar conditions who did not receive an NASG. Methods:This observational study analyzed a historic cohort of 154 patients with PPH, secondary hypovolemic shock and signs of hypoperfusion who were admitted to this institution from 2012 to 2015. Group 1 (n= 77) was managed with NASG and Group 2 (n = 77) received interventions other than NASG. Hypoperfusion markers and maternal outcomes were compared in both groups. Results:Of 154 patients included in the analysis, 36.4% required a total abdominal hysterectomy (TAH) to achieve hemorrhage control, 98.2% of whom belonged to Group 2 and 1.8% to Group 1 (p = .001). The use of blood products was more common in Group 2 (p < .001), as was the administration of vasoactive agents. The mean number of days of hospitalization at the Obstetric High Dependency Unit (OHDU) was significantly lower in Group 1 and reached a statistically significantpvalue. Only two cases of maternal death occurred in Group 2. Discussion:The use of NASG in the management of PPH is a cost-effective strategy for patients with severe shock and signs of hypoperfusion and is optimal in a limited-resource scenario. In this study, the use of NASG was related to better outcomes in a statistically significant manner with better results regarding maternal outcomes such as uterine preservation and decreased transfusion requirements and hospital days. Conclusions:NASG, associated with the use of uterotonic agents and other strategies for PPH control, is a safe tool that helps reduce morbimortality in critically ill patients with PPH.
机译：目的：本文的目的是比较血液动力学和灌注参数以及患有患者的产后出血患者（PPH）的临床结果，作为干预包装的一部分，接受了非全体反锁服装（NASG）的治疗，其中一群患者在没有收到NASG的类似条件下。方法：该观察项研究分析了2012年至2015年从2012年至2015年被录取的PPH，继发性低血压休克患者的历史型群，二级低血血休克和患有的低渗患者。第1（N = 77）与NASG和第2组进行管理（n = 77）收到NASG以外的干预措施。两组比较了低杂化标志物和母体结果。结果：154例患者分析，36.4％所需总腹部子宫切除术（TAH），实现出血控制，其中98.2％属于第2组和1.8％至第1组（P = .001）。血液制品的使用在第2组（P <.001）中更常见（P <.001），vasoactive代理的给药是施用。产科高依赖性单位（OHDU）的平均天数在1组中显着降低，达到统计学上的高价值。 2.讨论中只发生了两种孕产妇死病例：NASG在PPH管理中的使用是对患者的严重休克患者的经济效益策略，在有限资源场景中最佳。在这项研究中，使用NASG的使用与统计学显着的方式有关，具有更好的结果，诸如子宫保存等孕产妇结果和降低的输血要求和医院日。结论：与使用子偶联药物和PPH对照的其他策略相关的NASG是一种安全的工具，有助于降低患有PPH的危重病人的病态。

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