A Case Report of Right Pneumonectomy with a Focus on the Right Ventricular Function and Hemodynamic Management

Abstract

Background: In patients undergoing pneumonectomy, intraoperative pulmonary and cardiac complications are the major cause of morbidity and mortality. Protective lung ventilation strategies may decrease the overall lung injury. Right, ventricular dysfunction may occur during the surgery and after the pneumonectomy, in the early postoperative period, with reduced RV ejection fraction and increased RV end-diastolic volume index, caused by increased RV afterload. Case report: We describe the case of a 28-year-old non-smoker female who underwent to a right pneumonectomy. The patient presented intraoperative hemodynamic instability and signs of RV dysfunction, requiring vasoactive amines and nitric oxide. Discussion: This article is intended to provide an overview of the anesthetic management for pneumonectomy including the hemodynamic management and considerations of the causes and management of right ventricular dysfunction.