Hi friends, We have a young lady who had premature rupture of membranes (PROM), had an emergency Cesarean section after 48Hrs, was already on prophylactic antibiotics (IV. Cephazolin) as per the protocol.
Intraoperatively developed refractory hypotension / full blown SIRS (Unexplained by low dose spinal), and chorio amnionitis - severe sepsis was suspected / and confirmed (High vag swab at admission revealed Klebsiella growth) considering 48 hrs of PROM. Sepsis profile / CVP line inserted for fluid administration and vasopressors support. Lactate was 4 and SCVO2 was 48%. (Hb-10g). Change of antibiotics as per the cultures and fluids and nor adr / organ supports etc. have helped her and is stabilizing. Her lactate improved and is within normal limits. *SCVO2 is still @ 55% *and *her Hb is 8.2g%*. CLinically she is doing good and on soft diet. Blood culture also was positive for klebsiella My question to the the expert is: My fellows were debating whether to give her couple of units of Packed cell transfusion in view of low ScVO2.....I seek you opinion as well - Does she need blood transfusion? She has come out of all organ dysfunctions (Renal / ALI / Low plt) and is asymptomatic and white cell counts are 10800/cumm, Polymorphs - 72%, Bands - 4%! Thanking you in advance! Regards, Sunil *------------* ** *Dr.Sunil T Pandya* * * *Hon. Secretary, Association of Obstetric Anaesthesiologists, India ( www.aoaindia.com)* *Hon. Secretary, Society of Obstetric Medicine, India* * * *Head, **Dept. of Anaesthesia, Pain and Critical Care,* *Fernandez Hospital (Health care for Women and the Newborn), ** www.fernandezhospital.com* * * *Director, Prerna Anaesthesia and Critical Care Services Pvt Ltd ( www.prernaanaesthesia.com)* *Hyderabad, India.* * *
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