Caesarean section in patients with heart-lung transplants: a report of three cases and review

Rigg, Carolyn; Bythell, V.; Bryson, M.; Halshaw, J.; Davidson, Jeffrey M.

doi:10.1054/ijoa.1999.0363

Cited by 11 publications

(5 citation statements)

References 25 publications

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“…Alpha and beta adrenoreceptors are intact and the heart responds normally to circulating catecholamines [9,10] . The denervated heart lacks the ability to maintain the cardiac output with reflex tachycardia in the presence of hypovolemia or vasodilatation [11] . Therefore, cardiac output is primarily dependent on preload and is initially augmented via increased stroke volume and subsequently maintained by increased heart rate, secondary to circulating catecholamines.…”

Section: Physiology Of Transplanted Heart and Specific Anaesthetic Co...mentioning

confidence: 99%

“…However, direct acting drugs such as adrenaline, isoprenaline and ephedrine increase the heart rate. Ephedrine has both direct and indirect actions and its overall effect is said to be reduced [11] . Exercise capacity is suboptimal after cardiac transplantation.…”

Section: Physiology Of Transplanted Heart and Specific Anaesthetic Co...mentioning

confidence: 99%

“…Cautious fluid administration is recommended [2] . Lung function tests may be normal, but lung compliance is reduced and ventilation-perfusion mismatch may occur [11] .…”

Section: Physiology Of Transplanted Lungs and Specific Anaesthetic Co...mentioning

confidence: 99%

“…General anaesthesia carries an increased risk of postoperative chest infection due to the loss of cough reflex and impaired mucociliary clearance. As discussed above, patients need to be completely reversed and conscious before extubation [11] .…”

Section: Anaesthetic Techniquementioning

confidence: 99%

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Two consecutive major lower limb operations in a heart-lung transplant recipient during COVID pandemic: A case report and literature review

Bhaktavatsalam¹,

Hambly²,

Ferguson³

et al. 2022

Int. J. Med. Anesthesiology

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Introduction: Combined heart and lung transplant is a rare procedure performed for patients with congenital heart disease and end stage pulmonary disease. Due to improvement in survival, non-cardiac surgeries are frequently performed in these patients and anaesthetists are involved in their perioperative management. Apart from increasing the physical and mental health risks, COVID-19 pandemic has posed an additional challenge to health care providers in the management of these immunosuppressed patients. Case presentation: We report a case of a 64-year-old female patient with a previous combined heart and lung transplant who underwent two consecutive lower limb surgeries during COVID pandemic. Conclusion: Meticulous preoperative assessment involving multidisciplinary team, knowledge of the pathophysiology of heart-lung transplant patients, choosing appropriate anaesthetic technique is vital in successful management of these patients. Psychological implications of COVID-19 pandemic in immunosuppressed patients should be considered.

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Section: Physiology Of Transplanted Heart and Specific Anaesthetic Co...mentioning

confidence: 99%

Section: Physiology Of Transplanted Heart and Specific Anaesthetic Co...mentioning

confidence: 99%

“…Cautious fluid administration is recommended [2] . Lung function tests may be normal, but lung compliance is reduced and ventilation-perfusion mismatch may occur [11] .…”

Section: Physiology Of Transplanted Lungs and Specific Anaesthetic Co...mentioning

confidence: 99%

Section: Anaesthetic Techniquementioning

confidence: 99%

See 2 more Smart Citations

Two consecutive major lower limb operations in a heart-lung transplant recipient during COVID pandemic: A case report and literature review

Bhaktavatsalam¹,

Hambly²,

Ferguson³

et al. 2022

Int. J. Med. Anesthesiology

View full text Add to dashboard Cite

show abstract

“…Given that the major reason for lowering blood pressure in pre‐eclampsia is reduction of the risk of intracerebral haemorrhage, we were left uncertain as to what the goals regarding blood pressure should be, but decided to accept blood pressures somewhat higher than we would normally in the context of severe pre‐eclampsia. A vasodilator may indeed have lowered blood pressure further, but with a risk of severe hypotension, which might have threatened both fetuses – a complication we have experienced in the past [3, 4].…”

mentioning

confidence: 99%