TY - JOUR
T1 - Operative hysteroscopy intravascular absorption syndrome is more than just the gynecological transurethral resection of the prostate syndrome
T2 - A case series and literature review
AU - Wang, Ming Tse
AU - Chang, Chuen Chau
AU - Hsieh, Ming Hui
AU - Chang, Ching Wen
AU - Fan Chiang, Yu Hsuan
AU - Tsai, Hsiao Chien
N1 - Funding Information:
This manuscript was edited by Wallace Academic Editing.
Publisher Copyright:
© 2020
PY - 2020/9
Y1 - 2020/9
N2 - Objective: Operative hysteroscopy intravascular absorption (OHIA) syndrome refers to fluid overload complications from operative hysteroscopies. Despite guidelines for safe operative hysteroscopies, instances of OHIA syndrome have been reported. Case report: We reported three cases of OHIA syndrome. A 48-year-old female patient presented net irrigation fluid of 11,900 mL and developed severe metabolic acidosis, conscious disturbance, acute pulmonary edema, and unexpected intensive care unit admission. A 49-year-old female patient presented net irrigation fluid of 4500 mL and developed desaturation and acute pulmonary edema. A 45-year-old female patient presented net irrigation fluid of 2400 mL and developed hyponatremia, increased hilum lung marking, and prolonged postanesthesia care unit observation. Conclusion: For safety, clinicians should use isotonic electrolyte–containing distension media and bipolar electrosurgical instruments in operative hysteroscopies, and fluid status should be monitored closely, particularly at net and total irrigation amounts >3000 and > 8000 mL, respectively. Intrauterine pressure should also be minimized to reduce intravascular and intraperitoneal absorption.
AB - Objective: Operative hysteroscopy intravascular absorption (OHIA) syndrome refers to fluid overload complications from operative hysteroscopies. Despite guidelines for safe operative hysteroscopies, instances of OHIA syndrome have been reported. Case report: We reported three cases of OHIA syndrome. A 48-year-old female patient presented net irrigation fluid of 11,900 mL and developed severe metabolic acidosis, conscious disturbance, acute pulmonary edema, and unexpected intensive care unit admission. A 49-year-old female patient presented net irrigation fluid of 4500 mL and developed desaturation and acute pulmonary edema. A 45-year-old female patient presented net irrigation fluid of 2400 mL and developed hyponatremia, increased hilum lung marking, and prolonged postanesthesia care unit observation. Conclusion: For safety, clinicians should use isotonic electrolyte–containing distension media and bipolar electrosurgical instruments in operative hysteroscopies, and fluid status should be monitored closely, particularly at net and total irrigation amounts >3000 and > 8000 mL, respectively. Intrauterine pressure should also be minimized to reduce intravascular and intraperitoneal absorption.
KW - Fluid overload
KW - Gynecological TURP syndrome
KW - Net irrigation & total irrigation amount=> therapeutic irrigations
KW - OHIA syndrome
KW - Operative hysteroscopy=> hysteroscopic surgery
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U2 - 10.1016/j.tjog.2020.07.022
DO - 10.1016/j.tjog.2020.07.022
M3 - Article
C2 - 32917330
AN - SCOPUS:85088865732
SN - 1028-4559
VL - 59
SP - 748
EP - 753
JO - Taiwanese Journal of Obstetrics and Gynecology
JF - Taiwanese Journal of Obstetrics and Gynecology
IS - 5
ER -