Abstract:
:The ex utero intrapartum treatment (EXIT) procedure is designed to guarantee sufficient oxygenation for a foetus at risk of airway obstruction. This is achieved by improving lung ventilation, usually by establishing an airway during caesarean delivery whilst preserving the foetal-placental circulation temporarily. Indications for the EXIT procedure have extended from its original use in reversing iatrogenic tracheal obstruction in congenital diaphragmatic hernia to naturally occurring upper airway obstructions. We report our experience with a new and rarely mentioned indication for the EXIT procedure, intra-thoracic volume expansions. The elaboration of lowest risk scenarios through balancing risks with alternative options, foetal or neonatal intervention and coordination between professionals from various disciplines are the most important conditions for a successful EXIT procedure. The EXIT procedure requires a caesarean section that specifically differs from the traditional caesarean section during which uterine tone is maintained to minimize maternal bleeding. To guarantee foetal oxygenation during the EXIT procedure, profound uterine relaxation is desired. To gain time with optimal placental oxygenation in order to safely perform an airway intervention in a baby at risk of hypoxia may require deep inhalation anaesthesia and/or tocolytic agents. We review the EXIT procedure and present a case series from the University Hospital of Geneva that contrasts with the common indication for the EXIT procedure usually based on upper airway obstruction by its exclusive indication for intra-thoracic malformations/diseases.
journal_name
Swiss Med Wklyjournal_title
Swiss medical weeklyauthors
Kern C,Ange M,Morales,Peiry B,Pfister REdoi
2007/19/smw-11526subject
Has Abstractpub_date
2007-05-19 00:00:00pages
279-85issue
19-20eissn
1424-7860issn
1424-3997pii
smw-11526journal_volume
137pub_type
杂志文章,评审abstract:BACKGROUND:Several publications reported on the safety and efficacy of bortezomib, a novel first-in-class anti-cancer agent, in the treatment of relapsed/refractory multiple myeloma in controlled clinical trials. Complementary data on the experience with bortezomib in daily oncology practice are needed. We report on th...
journal_title:Swiss medical weekly
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journal_title:Swiss medical weekly
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journal_title:Swiss medical weekly
pub_type: 杂志文章
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pub_type: 历史文章,杂志文章,评审
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pub_type: 杂志文章
doi:2003/21/smw-10230
更新日期:2003-05-31 00:00:00
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doi:10.4414/smw.2010.13094
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journal_title:Swiss medical weekly
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pub_type: 杂志文章,meta分析
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pub_type: 杂志文章,评审
doi:
更新日期:2006-06-10 00:00:00
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pub_type: 杂志文章,评审
doi:2003/09/smw-10028
更新日期:2003-03-08 00:00:00
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pub_type: 杂志文章,评审
doi:10.4414/smw.2015.14138
更新日期:2015-05-29 00:00:00
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pub_type: 杂志文章,评审
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journal_title:Swiss medical weekly
pub_type: 杂志文章
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更新日期:2008-05-31 00:00:00