Résumé
We present successful epidural anesthesia and assisted mechanical ventilation in a parturient woman with respiratory failure. A 41-year-old woman at 35 weeks' of gestation was entering labor. She was pneumonectomized on the left, had bronchiectasis on the remnant lung, and was under assisted mechanical ventilation by continuous positive airway pressure (CPAP) because of severely restricted lung function and superimposed pneumonia. We administered continuous epidural analgesia for vaginal delivery, and extended it for cesarean section after failure of vaginal delivery. During the procedure, her ventilation was continuously assisted by CPAP. The maternal and fetal outcomes were successful.
Sujets)
Femelle , Humains , Grossesse , Analgésie péridurale , Anesthésie , Anesthésie péridurale , Dilatation des bronches , Césarienne , Ventilation en pression positive continue , Poumon , Pneumopathie infectieuse , Ventilation artificielle , Insuffisance respiratoire , VentilationRésumé
Aortoiliac occlusive disease occurs commonly in patients with peripheral arterial disease. Aortofemoral bypass is the most common surgical procedure to treat aortoiliac occlusive disease. Intraoperative renal artery embolism is rare complication that may occur during aortofemoral bypass in patients with aortoiliac occlusive disease. It is very important to prevent the risk of subsequent renal artery thrombotic or atheromatous embolism during aortofemoral bypass in patients with juxtarenal aortic occlusion because of accidentally dislodging fragments or atheromatous emboli into the renal arteries. Emboli to one or more major renal arteries are an occasional cause of renal failure. We report a case of renal artery embolism in patient with aortoiliac occlusive disease and unilateral renal atrophy during aortobifemoral bypass graft.