Severe pulmonary hypertension in a patient with bronchiectasis complicated by cor pulmonale and a right-to-left shunt presenting for surgery
| Autor: | T. C. Low, K. S. Lim, C. F. Yim |
|---|---|
| Rok vydání: | 2002 |
| Předmět: |
Male
medicine.medical_specialty Colon Right-to-left shunt Hypertension Pulmonary Critical Care and Intensive Care Medicine Persistent fetal circulation Heart Septal Defects Atrial Bronchospasm 03 medical and health sciences 0302 clinical medicine Pulmonary Heart Disease medicine.artery Preoperative Care medicine Humans 030212 general & internal medicine Colectomy business.industry 030208 emergency & critical care medicine Perioperative Middle Aged medicine.disease Pulmonary hypertension Anesthetics Combined respiratory tract diseases Surgery Bronchiectasis Anesthesiology and Pain Medicine medicine.anatomical_structure Anesthesia Vascular resistance Patent foramen ovale Salbutamol Anesthesia Intravenous medicine.symptom business Colorectal Neoplasms Preanesthetic Medication medicine.drug |
| Zdroj: | Anaesthesia and intensive care. 30(4) |
| ISSN: | 0310-057X |
| Popis: | A patient with advanced bronchiectasis, severe pulmonary hypertension complicated by cor pulmonale and a right-to-left shunt at atrial level presented for sigmoid colectomy. We outline the potential perioperative problems of this situation, discuss the perioperative risks and describe our clinical approach. A total intravenous anaesthetic technique using midazolam, fentanyl, ketamine and rocuronium was used to minimize changes in pulmonary and systemic vascular resistance and not induce bronchospasm. Preoperative nebulized salbutamol and ipratroprium were given to prevent bronchospasm and adrenaline and noradrenaline were infused to maintain cardiac output and the balance between systemic and pulmonary vascular resistance. |
| Databáze: | OpenAIRE |
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