Fatal cardiac tamponade that developed in the post-anesthesia care unit: a rare complication after lung lobectomy

Revista Brasileira de Anestesiologia

关键词: Cardiac tamponade;    Echocardiography;    Transesophageal;    Pneumonectomy;    Anesthesia recovery period;   

DOI  :  10.1016/j.bjane.2017.10.009

来源: DOAJ

【 摘 要 】

AbstractBackground and objectives: Cardiac tamponade is potentially fatal medical condition, which rarely occurs as a complication of lung lobectomy. We present the first case of cardiac tamponade to develop in a Post-Anesthesia Care Unit following a lung lobectomy.Case report: A 54-year-old man with pulmonary squamous cell carcinoma underwent an apparently uncomplicated lung lobectomy. His hemodynamics was unremarkable throughout the surgery and initially in the Post-Anesthesia Care Unit. However, after 5 min in the Post-Anesthesia Care Unit, he suddenly became hypotensive and dyspneic. He responded poorly to inotropics and fluid resuscitation. Transesophageal echocardiography conducted by an anesthesiologist who suspected a cardiac etiology revealed a pericardial effusion compressing the heart. After a failed attempt of pericardiocentesis, an emergency pericardial window operation was performed. The patient improved dramatically once the heart was decompressed.Conclusion: Since cardiac tamponade is generally not suspected as a cause of hemodynamic instability after a lung lobectomy, as it was in this case, a misdiagnosis of the patient's condition may have led to improper management resulting in death. As anesthesiologists are often involved in the initial resuscitation of morbid patients in Post-Anesthesia Care Units, their acquaintance with various postoperative complications and competence in echocardiography for assessing cardiac problems may contribute to patient survival.

【 授权许可】

Unknown