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Anesthesia and analgesia · Aug 2013
Case ReportsCase report: 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.
- 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
- Anesth. Analg. 2013 Aug 1; 117 (2): 449452449-52.
AbstractAmniotic 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.
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