title: Beneficial effect of epidural anesthesia on oxygen consumption in a parturient with adult respiratory distress syndrome.
abstract: Multifactorial increases in oxygen consumption during labor may exceed available oxygen supply. Cumulative subclinical oxygen debt could be clinically detrimental to both patient and fetus. We have reported the use of continuous mixed venous oxygen saturation monitoring to identify changes in oxygen consumption after painful uterine contractions in a critically ill parturient. We used continuous venous saturation monitoring to document the effects of epidural analgesia on oxygen balance in our patient. The absence of venous desaturation with contractions after abatement of labor pains confirmed that pain was the major cause of increased oxygen consumption in this critically ill parturient. Broader use of mixed venous saturation monitoring may allow detection of oxygen deficits during labor and direct appropriate therapy in other critically ill parturients. Similar applications and results have been noted for other disease states in nonpregnant patients.
authors.affiliation: Department of Anesthesia, University of Cincinnati College of Medicine, Ohio.
authors.forename: W E
authors.initials: WE
authors.lastname: Ackerman
authors.forename: J M
authors.initials: JM
authors.lastname: Molnar
authors.forename: M M
authors.initials: MM
authors.lastname: Juneja
mesh_terms: D000328:Adult; D015360:Analgesia, Epidural / Q000379:methods / Q000592:standards*; D000767:Anesthesia, Epidural / Q000379:methods / Q000592:standards*; D000773:Anesthesia, Obstetrical / Q000379:methods / Q000592:standards*; D002585:Cesarean Section; D016638:Critical Illness; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008991:Monitoring, Physiologic; D007744:Obstetric Labor Complications / Q000378:metabolism / Q000503:physiopathology / Q000628:therapy*; D010092:Oximetry; D010101:Oxygen Consumption; D011247:Pregnancy; D012128:Respiratory Distress Syndrome / Q000378:metabolism / Q000503:physiopathology / Q000628:therapy*; D014939:Work of Breathing