Anesthesia Management for the Patient with Chronic Decompensated Heart Failure and Low Cardiac Output Undergoing CABG with Advanced Cardiac Monitoring: A Case Report.

Autor: Dayani A; Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran., Faritous SZ; Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran., Amniati S; Department of Anesthesiology, Iran University of Medical Sciences, Tehran, Iran., Bakhshande H; Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran., Zamani A; Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran., Ghanbari M; Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
Jazyk: angličtina
Zdroj: Anesthesiology and pain medicine [Anesth Pain Med] 2023 Jan 20; Vol. 13 (1), pp. e133796. Date of Electronic Publication: 2023 Jan 20 (Print Publication: 2023).
DOI: 10.5812/aapm-133796
Abstrakt: Introduction: Heart failure (HF) is a complex clinical syndrome caused by a structural or functional heart disorder. One of the most important challenges for anesthesiologists is the management of anesthesia in patients with severe heart failure, which has been facilitated by advanced monitoring systems.
Case Presentation: The patient was a 42-year-old man with a history of hypertension (HTN) and HF with involvement of the three coronary arteries (3VD) with ejection fraction (EF) 15%. He was also a candidate for elective CABG. In addition to the insertion of arterial line in the left radial artery and the Swan-Ganz catheter in the pulmonary artery, the patient was also monitored by the Edwards Lifesciences Vigilance II for cardiac index (CI) and intravenous mixed blood oxygenation (ScvO 2 ). Hemodynamic changes during and after surgery, as well as during inotrope infusion, were controlled, and the amount of fluid therapy was calculated by gold direct therapy (GDT) method.
Conclusions: Using PA catheter with advanced monitoring and GDT-based fluid therapy guaranteed a safe anesthesia in this patient with severe heart failure and EF < 20%. Moreover, the postoperative complications and duration of ICU stays were significantly reduced.
Competing Interests: Conflict of Interests: The authors declare that they have no conflict of interests.
(Copyright © 2023, Author(s).)
Databáze: MEDLINE
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