ACUTE HEMODYNAMIC AND RESPIRATORY EFFECTS OF AMNIOTIC-FLUID EMBOLISM IN THE PREGNANT GOAT MODEL

OBJECTIVE: Our purpose was to determine the acute-phase central hemody namic and respiratory effects of raw, filtered, filtered and boiled, a nd meconium-containing amniotic fluid. STUDY DESIGN: Pregnant goats (C apra hircus) in the last one third of pregnancy were given freshly col lected autologous amniotic fluid in a volume of 2.5 ml/kg of body weig ht. Observations were then made at 10, 30, 60, 120, and 180 minutes af ter amniotic fluid embolism. Pulmonary artery catheters and femoral ar tery lung water catheters were placed for specimen and data collection . RESULTS: Marked pressor responses were observed in both the pulmonar y and systemic circulations with all amniotic fluid infusions. The pre ssor response was similar with raw, filtered, and filtered and boiled amniotic fluid. The pressor response seen with amniotic fluid containi ng meconium was significantly greater than that seen with the other fo rms. No significant effects were observed on cardiac or respiratory fu nction except in the meconium group, where transient left ventricular dysfunction was accompanied by an acute increase in extravascular lung water and dysoxia. CONCLUSIONS: The Capra hircus model is appropriate for the further study of amniotic fluid embolism. The acute pressor e ffects are transient and involve both the systemic and pulmonary circu lations. Left ventricular dysfunction and dysoxia were observed only w ith embolism of amniotic fluid containing meconium.