Best Practice & Research Clinical Obstetrics & Gynaecology
Volume 24, Issue 3 , Pages 383-400 , June 2010

Cardiopulmonary resuscitation and the parturient

  • Maya S. Suresh, M.D (Professor and Interim Chair)

      Affiliations

    • Tel.: +1 713 798 1887; Fax: +1 713 798 6374.
  • ,
  • Chawla LaToya Mason, M.D (Assistant Professor)

      Affiliations

    • Corresponding Author InformationCorresponding author. Tel.: +1 713 798 1887; Fax: +1 713 798 6374.
  • ,
  • Uma Munnur, M.D (Associate Professor)

      Affiliations

    • Tel.: +1 713 798 1887; Fax: +1 713 798 6374.

References 

  1. Datner E, Promes S. In: Tintinalli’s emergency medicine. Resuscitation in pregnancy. The McGraw-Hill Co; 2006;p. 254
  2. Neufeld J. Trauma in pregnancy. In: Marx  editors. Rosen's emergency medicine: concepts and clinical practices. 6th ed.. Mosby; 2006;[chapter 35]
  3. Laver S, Farrow C, Turner D, et al. Mode of death after admission to an intensive care unit following cardiac arrest. Intensive Care Med. 2004;30(11):2126–2128
  4. Nichol G, Stiell IG, Laupacis A, et al. A cumulative meta-analysis of the effectiveness of defibrillator-capable emergency medical services for victims of out-of-hospital cardiac arrest. Ann Emerg Med. 1999;34(4 Pt 1):517–525
  5. American Heart Association . 10-8 cardiac arrest associated with pregnancy. Circulation. J Am Heart Assoc. 2005;112(IV):150–153
  6. Mild therapeutic hypothermia to improve the neurologic outcome after cardiac arrest. N Engl J Med. 2002;346(8):549–556
  7. Bernard SA, Gray TW, Buist MD, et al. Treatment of comatose survivors of out-of-hospital cardiac arrest with induced hypothermia. N Engl J Med. 2002;346(8):557–563
  8. Rittenberger JC, Kelly E, Jang D, et al. Successful outcome utilizing hypothermia after cardiac arrest in pregnancy: a case report. Crit Care Med. 2008;36(4):1354–1356
  9. D’Cruz BJ, Fertig KC, Filiano AJ, et al. Hypothermic reperfusion after cardiac arrest augments brain-derived neurotrophic factor activation. J Cereb Blood Flow Metab. 2002;22(7):843–851
  10. Hicks SD, DeFranco DB, Callaway CW. Hypothermia during reperfusion after asphyxial cardiac arrest improves functional recovery and selectively alters stress-induced protein expression. J Cereb Blood Flow Metab. 2000;20(3):520–530
  11. Sterz F, Safar P, Tisherman S, et al. Mild hypothermic cardiopulmonary resuscitation improves outcome after prolonged cardiac arrest in dogs. Crit Care Med. 1991;19(3):379–389
  12. Wali A, Suresh MS. Maternal morbidity, mortality, and risk assessment. Anesthesiol Clin. 2008;26(1):197–230,ix
  13. Chanimov M, Ben Shlomo I, Chayen B, et al. Amniotic fluid embolism: a plea for better brain protection 1. Isr Med Assoc J. 2008;10(2):154–155
  14. Gist RS, Stafford IP, Leibowitz AB, et al. Amniotic fluid embolism. Anesth Analg. 2009;108(5):1599–1602
  15. Hawkins JL, Koonin LM, Palmer SK, et al. Anesthesia-related deaths during obstetric delivery in the United States, 1979–1990. Anesthesiology. 1997;86(2):277–284
  16. Hawkins JL. Anesthesia-related maternal mortality. Clin Obstet Gynecol. 2003;46(3):679–687
  17. In:  Lewis G editors. Confidential enquiry into maternal and child health. Saving mother’s lives: review maternal deaths to make motherhood safer–2003–2005 The seventh report on confidential enquiries into maternal deaths in the United Kingdom. London: CEMACH. CEMACH; 2007;Chittern Court, 188 Baker Street, London, NW1 5SD
    Ref type: report
  1. Cooper GM, McClure JH. Maternal deaths from anaesthesia. An extract from Why Mothers Die 2000–2002, the confidential enquiries into maternal deaths in the United Kingdom: chapter 9.. Br J Anaesth. 2005 Apr;94(4):417–423
  2. Davies JM, Posner KL, Lee LA, et al. Liability associated with obstetric anesthesia: a closed claims analysis. Anesthesiology. 2009;110(1):131–139
  3. Awan R, Nolan JP, Cook TM. Use of a ProSeal laryngeal mask airway for airway maintenance during emergency Caesarean section after failed tracheal intubation. Br J Anaesth. 2004;92(1):144–146
  4. Bailey SG, Kitching AJ. The laryngeal mask airway in failed obstetric tracheal intubation. Int J Obstet Anesth. 2005;14(3):270–271
  5. Bullingham A. Use of the ProSeal laryngeal mask airway for airway maintenance during emergency caesarean section after failed intubation. Br J Anaesth. 2004;92(6):903
  6. Gonzalez GG, Marenco de la Fuente ML, Bertomeu CM. Fastrach mask to resolve a difficult airway during emergency cesarean section, Rev Esp Anestesiol Reanim. 2005;52(1):56–57
  7. Keller C, Brimacombe J, Lirk P, et al. Failed obstetric tracheal intubation and postoperative respiratory support with the ProSeal laryngeal mask airway. Anesth Analg. 2004;98(5):1467–1470
  8. Minville V, N’guyen L, Coustet B, et al. Difficult airway in obstetric using Ilma-Fastrach. Anesth Analg. 2004;99(6):1873
  9. Sharma B, Sahai C, Sood J, et al. The ProSeal laryngeal mask airway in two failed obstetric tracheal intubation scenarios. Int J Obstet Anesth. 2006;15(4):338–339
  10. Vaida SJ, Gaitini LA. Another case of use of the ProSeal laryngeal mask airway in a difficult obstetric airway. Br J Anaesth. 2004;92(6):905
  11. Case Report. Difficult Airway. Case Report 2, 78–83. 2001.
    Ref type: case
  1. Zand F, Amini A. Use of the laryngeal tube-S for airway management and prevention of aspiration after a failed tracheal intubation in a parturient. Anesthesiology. 2005;102(2):481–483
  2. Stroumpoulis K, Pagoulatou A, Violari M, et al. Videolaryngoscopy in the management of the difficult airway: a comparison with the Macintosh blade. Eur J Anaesthesiol. 2009;26(3):218–222
  3. Kaplan MB, Berci G. Videolaryngoscopy in the management of the difficult airway 1. Can J Anaesth. 2004;51(1):94–96
  4. Gray K, Lucas N, Robinson PN, et al. A case series of successful videolaryngoscopic intubations in obstetric patients. Int J of Obstetric Anesthesia. 2009;18:S1–S613
  5. Auroy Y, Narchi P, Messiah A, et al. Serious complications related to regional anesthesia: results of a prospective survey in France. Anesthesiology. 1997;87(3):479–486
  6. Brown DL, Ransom DM, Hall JA, et al. Regional anesthesia and local anesthetic-induced systemic toxicity: seizure frequency and accompanying cardiovascular changes. Anesth Analg. 1995;81(2):321–328
  7. Santos AC, DeArmas PI. Systemic toxicity of levobupivacaine, bupivacaine, and ropivacaine during continuous intravenous infusion to nonpregnant and pregnant ewes. Anesthesiology. 2001;95(5):1256–1264
  8. Faccenda KA, Finucane BT. Complications of regional anaesthesia incidence and prevention. Drug Saf. 2001;24(6):413–442
  9. Corcoran W, Butterworth J, Weller RS, et al. Local anesthetic-induced cardiac toxicity: a survey of contemporary practice strategies among academic anesthesiology departments. Anesth Analg. 2006;103(5):1322–1326
  10. Weinberg GL. Current concepts in resuscitation of patients with local anesthetic cardiac toxicity. Reg Anesth Pain Med. 2002;27(6):568–575
  11. Atta E, Gardner M. Cardiopulmonary resuscitation in pregnancy. Obstet Gynecol Clin North Am. 2007;34(3):585–597xiii
  12. Heavner JE, Dryden CF, Sanghani V, et al. Severe hypoxia enhances central nervous system and cardiovascular toxicity of bupivacaine in lightly anesthetized pigs. Anesthesiology. 1992;77(1):142–147
  13. Groban L, Deal DD, Vernon JC, et al. Cardiac resuscitation after incremental overdosage with lidocaine, bupivacaine, levobupivacaine, and ropivacaine in anesthetized dogs. Anesth Analg. 2001;92(1):37–43
  14. Long WB, Rosenblum S, Grady IP. Successful resuscitation of bupivacaine-induced cardiac arrest using cardiopulmonary bypass. Anesth Analg. 1989;69(3):403–406
  15. Groban L, Butterworth J. Lipid reversal of bupivacaine toxicity: has the silver bullet been identified?. Reg Anesth Pain Med. 2003;28(3):167–169
  16. Weinberg G, Ripper R, Feinstein DL, et al. Lipid emulsion infusion rescues dogs from bupivacaine-induced cardiac toxicity. Reg Anesth Pain Med. 2003;28(3):198–202
  17. Weinberg GL. Lipid infusion therapy: translation to clinical practice. Anesth Analg. 2008;106(5):1340–1342
  18. Litz RJ, Roessel T, Heller AR, et al. Reversal of central nervous system and cardiac toxicity after local anesthetic intoxication by lipid emulsion injection. Anesth Analg. 2008;106(5):1575–1577table
  19. Rosenblatt MA, Abel M, Fischer GW, et al. Successful use of a 20% lipid emulsion to resuscitate a patient after a presumed bupivacaine-related cardiac arrest. Anesthesiology. 2006;105(1):217–218
  20. Warren JA, Thoma RB, Georgescu A, et al. Intravenous lipid infusion in the successful resuscitation of local anesthetic-induced cardiovascular collapse after supraclavicular brachial plexus block. Anesth Analg. 2008;106(5):1578–1580
  21. Weinberg GL, Ripper R, Murphy P, et al. Lipid infusion accelerates removal of bupivacaine and recovery from bupivacaine toxicity in the isolated rat heart. Reg Anesth Pain Med. 2006;31(4):296–303
  22. Brull SJ. Lipid emulsion for the treatment of local anesthetic toxicity: patient safety implications. Anesth Analg. 2008;106(5):1337–1339
  23. Weinberg GL, VadeBoncouer T, Ramaraju GA, et al. Pretreatment or resuscitation with a lipid infusion shifts the dose-response to bupivacaine-induced asystole in rats. Anesthesiology. 1998;88(4):1071–1075
  24. Corman SL, Skledar SJ. Use of lipid emulsion to reverse local anesthetic-induced toxicity. Ann Pharmacother. 2007;41(11):1873–1877
  25. Felice K, Schumann H. Intravenous lipid emulsion for local anesthetic toxicity: a review of the literature. J Med Toxicol. 2008;4(3):184–191
  26. Rosenberg PH, Veering BT, Urmey WF. Maximum recommended doses of local anesthetics: a multifactorial concept. Reg Anesth Pain Med. 2004;29(6):564–575
  27. Stiles P, Prielipp RC. Intralipid treatment of bupicavaine toxicity. The Official Journal of the Anesthesia Patient Safety Foundation. 2009;24(No. 1):
    Ref type: electronic citation
  1. Weinberg GL. Treatment regimens. Lipid rescue resuscitation for cardiac toxicity 2007.
    Ref type: electronic citation
  1. Clark S. Critical care obstetrics. In: Danforth’s obstetrics and gynecology. Lippincott Williams and Wilkins; 2003;
  2. Houry D, Abbott J. Acute complications of pregnancy. In: Rosen’s emergency medicine: concepts and clinical practices. Marx; 2006;
  3. Mattox K, Goetzi L. Trauma in pregnancy. Crit Care Med. 2005;33:385–389
  4. Crochetiere C. Obstetric emergencies. Anesthesiol Clin North America. 2003;21(1):111–125
  5. Morrison L. General approach to the pregnant patient. In: Concepts and clinical practices. Mosby; 2006;
  6. Lapinsky SE, Kruczynski K, Seaward GR, et al. Critical care management of the obstetric patient. Can J Anaesth. 1997;44(3):325–329
  7. Lapinsky SE. Cardiopulmonary complications of pregnancy. Crit Care Med. 2005;33(7):1616–1622
  8. International guidelines 2000 for CPR and ECC. Part 8: advanced challenges in resuscitation. Section 3: special challenges in ECC. 3F: cardiac arrest associated with pregnancy. European Resuscitation Council. Resuscitation. 2000;46(1–3):293–295[Special Issue]
  9. Johnson MD, Atta E. Cardiopulmonary resuscitation. In:  Gambling DR,  Douglas MJ editor. Obstetric anesthesia and uncommon disorders. Philadelphia, PA: W.B. Saunders; 1998;p. 51–74
  10. Rees GA, Willis BA. Resuscitation in late pregnancy. Anaesthesia. 1988;43(5):347–349
  11. The International Liaison Committee on Resuscitation (ILCOR) consensus on science with treatment recommendations for pediatric and neonatal patients: pediatric basic and advanced life support. Pediatrics. 2006;117(5):e955–e977
  12. Nanson J, Elcock D, Williams M, et al. Do physiological changes in pregnancy change defibrillation energy requirements?. Br J Anaesth. 2001;87(2):237–239
  13. Gilbert ES, Harmon JS. Manual of High Risk Pregnancy & Delivery. 3rd ed; 2003.
  14. Di Gregoria R. Vasopressin use in the NYC REMAC protocols: A teaching reference. Regional Emergency Medical Services Council of New York; 2001;
  15. Cummins R. ACLS provider manual. Dallas: American Heart Association; 2001;
  16. Katz VL, Dotters DJ, Droegemueller W. Perimortem cesarean delivery. Obstet Gynecol. 1986;68(4):571–576
  17. DePace NL, Betesh JS, Kotler MN. ‘Postmortem’ cesarean section with recovery of both mother and offspring. JAMA. 1982;248(8):971–973
  18. Banks A. Maternal resuscitation: plenty of room for improvement. Int J Obstet Anesth. 2008;17(4):289–291
  19. American heart association in collaboration with the International Liason Committee on Resuscitation. Guideliness 2000 for cardiopulmonary resuscitation and emergency cardiovascular Care: international Consensus on science, Part 8: advanced Advancec Challenges in Resuscitation: Section 3: advanced Challenges in ECC. Circulation. 2000;102(Suppl. 1):1229–1252
  20. Cummins RO, Hazinski MF, Zelop CM. Cardiac arrest associated with pregnancy. In:  Cummins R,  Hazinski M,  Field J editor. ACLS – The Reference Textbook. Dallas: American Heart Association; 2003;p. 143–158
  21. Morris S, Stacey M. Resuscitation in pregnancy. BMJ. 2003;327(7426):1277–1279
  22. Boyd R, Teece S. Towards evidence-based emergency medicine: best BETs from the Manchester Royal Infirmary. Perimortem caesarean section. Emerg Med J. 2002;19(4):324–325
  23. Oates S, Williams GL, Rees GA. Cardiopulmonary resuscitation in late pregnancy. BMJ. 1988;297(6645):404–405
  24. Lipman S, Carvalho BCS. The 5-minute rule for perimortem cesarean delivery: should we move tot he operating room?. The Journal of the American Society of Anesthesiology, Inc. 2009;A1612:
    Ref type: abstract
  1. Strong TH, Lowe RA. Perimortem cesarean section. Am J Emerg Med. 1989;7(5):489–494
  2. Selden BS, Burke TJ. Complete maternal and fetal recovery after prolonged cardiac arrest. Ann Emerg Med. 1988;17(4):346–349
  3. Booth CM, Boone RH, Tomlinson G, et al. Is this patient dead, vegetative, or severely neurologically impaired? assessing outcome for comatose survivors of cardiac arrest. JAMA. 2004;291(7):870–879
  4. The Hypothermia after Cardiac Arrest Study Group . Mild therapeutic hypothermia to improve the neurologic outcome after cardiac arrest. N Engl J Med. 2002;346(8):549–556
  5. Bernard S, Buist M, Monteiro O, et al. Induced hypothermia using large volume, ice-cold intravenous fluid in comatose survivors of out-of-hospital cardiac arrest: a preliminary report. Resuscitation. 2003;56(1):9–13
  6. Bunch TJ, White RD, Gersh BJ, et al. Long-term outcomes of out-of-hospital cardiac arrest after successful early defibrillation. N Engl J Med. 2003;348(26):2626–2633
  7. International Liaison Committee on Resuscitation . Part 7.5. Postresuscitation support. Circulation. 2005;112:84–88
  8. Steen PA, Newberg L, Milde JH, et al. Hypothermia and barbiturates: individual and combined effects on canine cerebral oxygen consumption. Anesthesiology. 1983;58(6):527–532
  9. Colbourne F, Sutherland G, Corbett D. Postischemic hypothermia. A critical appraisal with implications for clinical treatment. Mol Neurobiol. 1997;14(3):171–201
  10. Ginsberg MD, Sternau LL, Globus MY, et al. Therapeutic modulation of brain temperature: relevance to ischemic brain injury. Cerebrovasc Brain Metab Rev. 1992;4(3):189–225
  11. Safar PJ, Kochanek PM. Therapeutic hypothermia after cardiac arrest. N Engl J Med. 2002;346(8):612–613
  12. Hachimi-Idrissi S, Corne L, Ebinger G, et al. Mild hypothermia induced by a helmet device: a clinical feasibility study. Resuscitation. 2001;51(3):275–281
  13. Cohen SE, Andes LC, Carvalho B. Assessment of knowledge regarding cardiopulmonary resuscitation of pregnant women. Int J Obstet Anesth. 2008;17(1):20–25
  14. Einav S, Matot I, Berkenstadt H, et al. A survey of labour ward clinicians’ knowledge of maternal cardiac arrest and resuscitation. Int J Obstet Anesth. 2008;17(3):238–242
  15. Clarke J, Butt M. Maternal collapse. Curr Opin Obstet Gynecol. 2005;17(2):157–160
  16. Cohen J, Singer P, Kogan A, et al. Course and outcome of obstetric patients in a general intensive care unit. Acta Obstet Gynecol Scand. 2000;79(10):846–850
  17. Pandey U, Russell IF, Lindow SW. How competent are obstetric and gynaecology trainees in managing maternal cardiac arrests?. J Obstet Gynaecol. 2006;26(6):507–508
  18. Deutchman M, Dresang L, Winslow D. Advanced life support in obstetrics (ALSO) international development. Fam Med. 2007;39(9):618–622
  19. Phenan GP. Fetal consideration. In: Golden (March). Blackwell Science; 2004;p. 593–611

PII: S1521-6934(10)00044-1

doi: 10.1016/j.bpobgyn.2010.01.002

Best Practice & Research Clinical Obstetrics & Gynaecology
Volume 24, Issue 3 , Pages 383-400 , June 2010