• Anesthesia and analgesia · Apr 2009

    Repeated episodes of respiratory distress in an obese parturient after cesarean delivery.

    • Bernard Wittels, Tamer A Attia, Abbas Al-Qamari, and Matthew P Jaycox.
    • Department of Anesthesiology, Rush Medical College, Rush University Medical Center, 1653 West Congress Parkway, Suite 739 Jelke, Chicago, IL 60612-3833, USA. bernard_wittels@rush.edu
    • Anesth. Analg. 2009 Apr 1;108(4):1246-8.

    AbstractA 25-yr-old obese parturient with mild asthma underwent an uneventful spinal anesthetic for primary cesarean delivery. Within 4 h after delivery, the patient twice developed acute shortness of breath, inspiratory stridor, and hypoxemia that required intubation. A battery of blood tests revealed no evidence of an allergic reaction. She had a normal echocardiogram and chest computed tomography, but her neck computed tomography showed an enlarged left thyroid lobe asymmetrically compressing the endotracheal tube cuff. We hypothesized that, after delivery, decreased maternal vascular capacitance increased central venous pressure such that venous engorgement of an undiagnosed goiter may have caused symptomatic tracheal compression.

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