Management of cesarean section in a patient with Fontan circulation: a case report of dramatic reduction of maternal oxygen consumption after delivery
Abstract Background The anesthetic management of cesarean sections in Fontan-palliated parturients requires strict hemodynamic control. However, patient management with central venous oxygen saturation (ScvO2) and oxygen consumption (VO2) has never been reported. Case presentation A 30-year-old woma...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2020-10-01
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| Series: | JA Clinical Reports |
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| Online Access: | http://link.springer.com/article/10.1186/s40981-020-00385-w |
| _version_ | 1818408114910658560 |
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| author | Kazutomo Saito Hiroaki Toyama Atsushi Okamoto Masanori Yamauchi |
| author_facet | Kazutomo Saito Hiroaki Toyama Atsushi Okamoto Masanori Yamauchi |
| author_sort | Kazutomo Saito |
| collection | DOAJ |
| description | Abstract Background The anesthetic management of cesarean sections in Fontan-palliated parturients requires strict hemodynamic control. However, patient management with central venous oxygen saturation (ScvO2) and oxygen consumption (VO2) has never been reported. Case presentation A 30-year-old woman, who had received a total cavopulmonary connection for tricuspid atresia, was planned to undergo cesarean section at 38 weeks’ gestation. During combined spinal-epidural anesthesia, ScvO2 in addition to arterial pressure-based cardiac output (APCO) and central venous pressure (CVP) was monitored, and the change of VO2 was evaluated. After delivery, her APCO was almost unchanged. However, her ScvO2 increased dramatically from 42.1 to 67.3% and her CVP increased from 9 to 11 mm Hg. The calculated mean maternal VO2 changed from 443 to 295 mL/min. Conclusions In a cesarean section for a Fontan-palliated parturient, ScvO2 dramatically increased and maternal VO2 decreased by more than 25% after delivery. |
| first_indexed | 2024-12-14T09:38:35Z |
| format | Article |
| id | doaj.art-13b8cf3518d74a769e55d7a4297de85f |
| institution | Directory Open Access Journal |
| issn | 2363-9024 |
| language | English |
| last_indexed | 2024-12-14T09:38:35Z |
| publishDate | 2020-10-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | JA Clinical Reports |
| spelling | doaj.art-13b8cf3518d74a769e55d7a4297de85f2022-12-21T23:07:51ZengSpringerOpenJA Clinical Reports2363-90242020-10-01611510.1186/s40981-020-00385-wManagement of cesarean section in a patient with Fontan circulation: a case report of dramatic reduction of maternal oxygen consumption after deliveryKazutomo Saito0Hiroaki Toyama1Atsushi Okamoto2Masanori Yamauchi3Anesthesiology and Perioperative Medicine, Tohoku University Graduate School of MedicineAnesthesiology and Perioperative Medicine, Tohoku University Graduate School of MedicineDepartment of Anesthesiology, Tohoku University HospitalAnesthesiology and Perioperative Medicine, Tohoku University Graduate School of MedicineAbstract Background The anesthetic management of cesarean sections in Fontan-palliated parturients requires strict hemodynamic control. However, patient management with central venous oxygen saturation (ScvO2) and oxygen consumption (VO2) has never been reported. Case presentation A 30-year-old woman, who had received a total cavopulmonary connection for tricuspid atresia, was planned to undergo cesarean section at 38 weeks’ gestation. During combined spinal-epidural anesthesia, ScvO2 in addition to arterial pressure-based cardiac output (APCO) and central venous pressure (CVP) was monitored, and the change of VO2 was evaluated. After delivery, her APCO was almost unchanged. However, her ScvO2 increased dramatically from 42.1 to 67.3% and her CVP increased from 9 to 11 mm Hg. The calculated mean maternal VO2 changed from 443 to 295 mL/min. Conclusions In a cesarean section for a Fontan-palliated parturient, ScvO2 dramatically increased and maternal VO2 decreased by more than 25% after delivery.http://link.springer.com/article/10.1186/s40981-020-00385-wAdult congenital heart diseaseTricuspid atresiaFontan circulationCesarean sectionCentral venous oxygen saturationOxygen consumption |
| spellingShingle | Kazutomo Saito Hiroaki Toyama Atsushi Okamoto Masanori Yamauchi Management of cesarean section in a patient with Fontan circulation: a case report of dramatic reduction of maternal oxygen consumption after delivery JA Clinical Reports Adult congenital heart disease Tricuspid atresia Fontan circulation Cesarean section Central venous oxygen saturation Oxygen consumption |
| title | Management of cesarean section in a patient with Fontan circulation: a case report of dramatic reduction of maternal oxygen consumption after delivery |
| title_full | Management of cesarean section in a patient with Fontan circulation: a case report of dramatic reduction of maternal oxygen consumption after delivery |
| title_fullStr | Management of cesarean section in a patient with Fontan circulation: a case report of dramatic reduction of maternal oxygen consumption after delivery |
| title_full_unstemmed | Management of cesarean section in a patient with Fontan circulation: a case report of dramatic reduction of maternal oxygen consumption after delivery |
| title_short | Management of cesarean section in a patient with Fontan circulation: a case report of dramatic reduction of maternal oxygen consumption after delivery |
| title_sort | management of cesarean section in a patient with fontan circulation a case report of dramatic reduction of maternal oxygen consumption after delivery |
| topic | Adult congenital heart disease Tricuspid atresia Fontan circulation Cesarean section Central venous oxygen saturation Oxygen consumption |
| url | http://link.springer.com/article/10.1186/s40981-020-00385-w |
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