English
TitleAnesthetic Case for Pulmonary Resection in a Hemodialysis Patient with Poor Cardiac Function Following Coronary Artery Bypass Grafting
Subtitle
AuthorsRyu Okutani, Koichi Suehiro, Nobuaki Kanemura
Authors(kana)
OrganizationDepartment of Anesthesiology, Osaka City General Hospital and Children's Hospital
JournalCirculation Control
Volume30
Number3
Page171-174
Year/Month2009/5
ArticleReport
PublisherJapan Society of Circulation Control in Medicine
Abstract「Abstract」The patient was a 51-year-old woman who received CABG at 49 years old, and developed poor left ventricular cardiac function (EF, 26%; %FS, 14% and diffuse hypokinesis) after the surgery. The patient was scheduled to undergo thoracoscopy-guided left upper lobe resection. Prior to anesthetic induction, a Flotrac/Vigilleo SystemTM for an arterial pressure line was placed. After starting differential lung ventilation, hypotension and low cardiac index were confirmed by the system, and dobutamine administration was initiated. After that, systolic pressure fluctuated at around 90mmHg, and surgery was completed without any intraoperative complications. 「Introduction」The number of patients on hemodialysis (HD) due to chronic renal failure continues to increase, and the number of patients undergoing surgery is also on the rise. Among perioperative complications associated with chronic renal failure patients, the incidence of acute heart failure and increased susceptibility to infection is high, and particularly with pulmonary resection, acute right ventricular heart failure can be easily induced by a rapid decrease in the pulmonary vascular bed, an increase in pulmonary vascular resistance or an increase in pulmonary vascular permeability.
PracticeBasic medicine
Keywordsanesthetic management, pulmonary resection, hemodialysis patient, poor cardiac function, Flotrac/Vigilleo SystemTM

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