happens from time to time. There are rare cases of gauze that falls within the peritoneal cavity after surgery and cesarean section. This gauze caused a widespread purulent peritonitis (acute inflammation of the peritoneum, serous membrane lining the abdominal cavity and organs contained therein, in the presence of pus).
Hence there was a bacteremia (Bacteria in the blood) and sepsis , which is an inflammatory response throughout the body to infection characterized by fever, tachycardia, hypotension, abnormal blood clotting, etc.
Now, here is the possible reason for the amputation of hands and feet.
of severe sepsis arises called septic shock, which implies a state of severe hypotension and tachycardia, more multi-organic dysfunction, which do not respond to common vasopressor administration of drugs or fluid replacement.
In septic shock, the patient should be transferred to an intensive care unit and that, in order to restore blood pressure, it goes to the administration of drugs very potent vaso-constrictors such as norepinephrine in continuous infusion and high doses.
Norepinephrine causes the arteries to constrict (decrease their diameter) to increase the pressure so that blood circulates.
But with the decline in the diameter of the arteries becomes insufficient irrigation in distal tissues ("far") as the fingers and toes. The more time is required noradrenaline to maintain blood pressure, more time is compromised circulation in the distal upper and lower limbs.
the end, the loss of blood supply causes gangrene, or tissue death. There remains the amputation of the hand and / or standing commitment to prevent the gangrene from spreading further.
Apparently septic shock was very severe and resistant to intensive, requiring many days of infusion of noradrenaline to give. Or maybe the doses were too high, or you may be given more time absolutely necessary. You can not tell.
What we must know is that there must be very careful with noradrenaline. We should not be used routinely. Only warranted in critically ill patients and to increase mean arterial pressure to 50 mmHg. Once it achieves this value must begin their gradual withdrawal.
And to think that once during a conversation about the SPAAR cardiac anesthesia, a small clinic fellow Anglo-Saxon (or something), who loves the "simulation", boasted that "she was so well with norepinephrine when used routinely to compensate for the hypotension produced by the association propofol / remifentanil in anesthesia. "
Ignorance is bold.
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