TY - JOUR
T1 - Acute Intraoperative Hypoxemia During Right Pneumonectomy-The Heart and Lung Interaction
T2 - A Case Report
AU - Barragan-Bradford, Diana
AU - Gaissert, Henning
AU - Vidal Melo, Marcos F.
N1 - Publisher Copyright:
Copyright © 2021 International Anesthesia Research Society.
PY - 2021/4/27
Y1 - 2021/4/27
N2 - A 75-year-old woman with a history of right-upper lobectomy for adenocarcinoma presented for a right completion pneumonectomy due to 2 new fluorodeoxyglucose-avid densities on the remaining lung. After uneventful anesthetic induction and surgical resection with modest blood loss, the patient developed refractory hypoxemia on emergence without significant hemodynamic changes. Despite delivery of fraction of inspired oxygen (Fio2) = 1.0, confirmed position of the double-lumen tube, and exclusion of common causes of hypoxemia, hypoxemia persisted. An emergent transesophageal echocardiogram revealed a significant intracardiac shunt due to a patent foramen ovale. Specific cardiorespiratory management to achieve a positive left-right heart pressure gradient resulted in prompt normoxemia and successful extubation.
AB - A 75-year-old woman with a history of right-upper lobectomy for adenocarcinoma presented for a right completion pneumonectomy due to 2 new fluorodeoxyglucose-avid densities on the remaining lung. After uneventful anesthetic induction and surgical resection with modest blood loss, the patient developed refractory hypoxemia on emergence without significant hemodynamic changes. Despite delivery of fraction of inspired oxygen (Fio2) = 1.0, confirmed position of the double-lumen tube, and exclusion of common causes of hypoxemia, hypoxemia persisted. An emergent transesophageal echocardiogram revealed a significant intracardiac shunt due to a patent foramen ovale. Specific cardiorespiratory management to achieve a positive left-right heart pressure gradient resulted in prompt normoxemia and successful extubation.
UR - http://www.scopus.com/inward/record.url?scp=85105091747&partnerID=8YFLogxK
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U2 - 10.1213/XAA.0000000000001454
DO - 10.1213/XAA.0000000000001454
M3 - Article
C2 - 33905387
AN - SCOPUS:85105091747
SN - 2325-7237
VL - 15
SP - e01454
JO - A&A practice
JF - A&A practice
IS - 4
ER -