Nurten KAYACAN, Levent DÖŞEMECİ, Bilge KARSLI, Meliha ERMAN

Ritodrin'e bağlı pulmoner ödem (Olgu sunumu)

Bu olgu sunumunun amacı ritodrin tedavisine bağlı olarak okut pulmoner ödem gelişen bir hastayı literatür desteği ile irdelemektir. 27 yaşında ve 27.gestasyonel haftasındaki primigradiv olgu prematür eylem nedeniyle ritodrin ile tokolitik tedaviye alındı.Ancak tedavinin 4. gününde hastada dispne, takipne, taşikardi gelişmesi üzerine tedavi sonlandırıldı.Bebeğin oblik pozisyonda olması ve eylemin durdurulamaması nedeniyle sezaryen planlandı.Hasta ameliyathaneye geldiğinde Sp$O_2$ % 76 idi.Hasta hemen uyutularak entübe edildi.% 100 $O_2$ inhalasyonu ile arteryal kan gazlarında Pa$O_2$ 54,1 mmHg,PaC$O_2$ 36,1 mmHg, Sa$O_2$ % 89,4 olarak belirlendi.Kan gazlarındaki hipoksinin operasyon süresince devam etmesi üzerine olgu postoperatif yoğun bakım ünitesine nakledildi.Burada 24 saat süreyle PEEP uygulayarak mekanik ventilasyona devam edildi.Postoperatif 1. gün kan gazı ve radyolojik olarak düzelme sağlanarak ekstübe edildi. Sonuç olarak ritodrin tedavisi alan olguların pulmoner ödem açısından preoperatif, intraoperatif ve postoperatif dönemde yakından takip edilmesi gerektiği düşüncesindeyiz.

Anahtar Kelimeler:

Tokoliz, Gebelik komplikasyonları, Akciğer ödemi, Solunum, yapay, Ritodrin, Cerrahi işlemler, operatif

Ritodrine induced pulmonary edema (Case report)

The aim oft his report is to describe a patient who developed acut pulmonary edema due to ritodrine administration. A 27-years-old primigravida with a gestation of 27 weeks was admitted in premature labor.The premature labor had been inhibited with ritodrine (Pre-par) admisson.However, at the fourth day of ritodrine administration, the patient had dyspnea, tachypnea and tachycardia.Ritodrine infusion was stopped for this reason.Cesarean section was planned because of oblique presentation.Periferic oxygen saturation (Sp$Ox_2$) on room air was 76 percent when the patient came into operating room.Immediately, the patient was anaesthetised.Arterial blood gasses analysis with 100 percent oxygen inhalation showed Pa$O_2$ 54,1 mmHg,PaC$O_2$ 36,1 mmHg,Sa$O_2$ 89,4 percent.Because of decrements of arterial blood gassess, the patient was transported intensive care unit after operation.The patient was ventilated with PEEP as mechanically during 24 hours postoperatively. Consequently, the respiratory status of patients receiving ritodrine should be closely assessed with respect to pulmonary edema preoperatively, peroperatively and postoperatively.

Keywords:

Tocolysis, Pregnancy Complications, Pulmonary Edema, Respiration, Artificial, Ritodrine, Surgical Procedures, Operative,

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