Procedure for specialized anesthesium-renamatological assistance in case of massive obstetric bleeding

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Abstract


The clinical protocol outlines the procedure for the provision of specialized anesthesia-resuscitation assistance in the case of massive obstetric hemorrhages, adopted in the Department of Anaesthesiology and Reanimation of the Ott. Institute of Obstetrics, Gynecology and Reproductology. The protocol emphasizes that the provision of full-fledged assistance with massive obstetric hemorrhages and hemorrhagic shock (GSH) is possible only in conditions of deployed operating room. The recommendations on the implementation of infusion-transfusion therapy (ITT), including venous access and the composition of ITT, on the use of vasoactive therapy, the choice of the method of anesthesia and drugs for its conduct. Other pharmacotherapy with GSH is indicated, including the features of the application of uterotonic drugs. The tactics of respiratory support, as well as the volume of hardware and laboratory monitoring, are presented. Recommendations for the management of patients in the post-shock period are given. The effectiveness of this clinical protocol is confirmed by many years of practice of the department.


Dmitriy M. Shirokov

Author for correspondence.
dm_shirokov@interzet.ru
FSBSI «The Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott»; Pavlov First Saint Petersburg State Medical University; Kirov Military Medical Academy
Russian Federation, 3, Mendeleevskaya line, Saint Petersburg, 199034; 6/9, Lva Tolstogo street, St. Petersburg, 197089; 6G, Akademika Lebedeva street, Saint-Petersburg, 194044

Head of the Department of anesthesiology and reanimation

Yury M. Korostelev

juko_71@mail.ru
FSBSI «The Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott»; Pavlov First Saint Petersburg State Medical University
Russian Federation, 3, Mendeleevskaya line, Saint Petersburg, 199034; 6/9, Lva Tolstogo street, St. Petersburg, 197089

MD. anesthesiologist of the Department of anesthesiology and reanimation

Irina V. Vartanova

ivartanova@mail.ru
FSBSI «The Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott»; Pavlov First Saint Petersburg State Medical University
Russian Federation, 3, Mendeleevskaya line, Saint Petersburg, 199034; 6/9, Lva Tolstogo street, St. Petersburg, 197089

MD. anesthesiologist of the Department of anesthesiology and reanimation

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