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Mechanical Ventilation of the Obstetric Patient
- In previous pearls, we have discussed ventilatory settings to avoid excessive volumes and limit plateau pressures to < 30 cm H2O
- Importantly, these settings have not be extensively evaluated in pregnant patients
- Some important pearls when ventilating the pregnant patient:
- Avoid hyperventilation, as this adversely affects uterine blood flow
- Optimize oxygenation to ensure adequate fetal oxygen delivery (us 100% FiO2)
- In the presence of adequate oxygenation, PaCOs values <= 60 mm Hg do not appear to be detrimental to the fetus
References
Lapinsky SE, Posadas-Calleja JG, McCullagh I. Clinical review: Ventilator strategies for obstetric, brain-injured, and obese patients. Crit Care 2009;13:206.