Critical arrhythmia associated with pulmonary artery catheterization in a parturient with severe pulmonary hypertension

George, Ronald B.; Olufolabi, Adeyemi J.; Muir, Holly A.

doi:10.1007/bf03022037

Cited by 10 publications

(7 citation statements)

References 5 publications

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“…Critical arrhythmias encountered in a parturient woman with severe pulmonary hypertension were solved by the total removal of the catheter. 13 In the sheep presented in this article, cardiac arrhythmias occurred that were not linked to the presence of the Swan-Ganz catheter by itself but specifically related to intermittent heating of the thermal filament of the catheter. Indeed, arrhythmias stopped when CCO measurement was switched off despite the fact that the position of the catheter did not change.…”

Section: Discussionmentioning

confidence: 82%

Cardiac arrhythmias related to continuous thermodilution cardiac output measurement in an anaesthetized sheep

Coppens

Moens

2009

Lab Anim

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A case of cardiac arrhythmias related to continuous thermodilution cardiac output (CCO) is reported. A sheep anaesthetized for experimental purpose was instrumented with a special Swan-Ganz catheter-type to be used for CCO measurements. One hour after starting the CCO monitoring, isolated ventricular extrasystoles were noticed on the electrocardiogram with an increasing frequency. Subsequently bursts of extrasystoles occurred. Atrioventricular dissociation was also observed. The peaks of temperature of the thermal filament were within the normal range and their presence was noticed when arrhythmias appeared. Mean blood pressure and cardiac output did not change during this episode. When the CCO was switched off, no more arrhythmias were observed. The CCO Swan-Ganz by itself did not generate any arrhythmia. The sheep recovered uneventfully. When arrhythmias occur during anaesthesia where CCO is used, a thermal filament induced origin of the arrhythmia must be considered.

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Section: Discussionmentioning

confidence: 82%

Cardiac arrhythmias related to continuous thermodilution cardiac output measurement in an anaesthetized sheep

Coppens

Moens

2009

Lab Anim

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“…Most of the patients of ALCAPA are at increased risk of varying arrhythmias perioperatively [17] and Pulmonary artery catheter (PAC) insertion increases this risk further [18] and so in our patient, we avoided Pulmonary artery catheter insertion and non invasive cardiac output monitoring was used. The goals of anesthetic management in such patients are to maintain systemic Oxygen saturation and to prevent untoward increases in myocardial Oxygen demand, such as tachycardia [19].…”

Section: Discussionmentioning

confidence: 95%

Anomalous origin of left main coronary artery from pulmonary artery in an adult: Peri-operative concerns

Nath

Kiran

Talwar

2010

Indian J Thorac Cardiovasc Surg

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Anomalous origin of the left coronary artery from the pulmonary artery is an infrequent and lethal anomaly which can be alleviated surgically. However, its timely diagnosis is important. The management of such patients is challenging for cardiac surgeons and anesthesiologists as they are vulnerable to myocardial ischemia from coronary steal, left ventricular dysfunction, dysrhythmias and pulmonary hypertension. In this report, we present an adult patient who underwent successful surgery for this anomaly. Clinical presentation, diagnosis and anesthetic management of such patients is discussed.

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“…The use of a pulmonary arterial catheter (PAC) is uncertain. [74][75][76] There is also no current evidence that PAC use improves outcomes in parturients with PAH and most centers do not routinely use these catheters. 6,17 Anesthetic Technique The hemodynamic principles of anesthetic management in women with PAH are the maintenance of oxygenation, normovolemia, normotension, minimizing catecholamine surges with adequate analgesia, and reducing ventricular preload in the immediate postpartum period.…”

Section: Peripartum Monitoringmentioning

confidence: 99%

Birth Control and Pregnancy Management in Pulmonary Hypertension

Olsson

Jaïs

2013

Semin Respir Crit Care Med

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Pregnancies in patients with pulmonary arterial hypertension (PAH) are associated with serious complications and mortality rates of more than 50%. Advanced medical therapies for PAH have been developed during the past years resulting in improved hemodynamics, exercise capacity, quality of life, and outcome. However, despite these advances, pregnancy in women with PAH is still associated with excessive maternal mortality. Consequently, all current guidelines strongly discourage pregnancy and recommend an effective method of contraception in women of childbearing age. If this fails, early pregnancy termination is advised. Those patients who choose to continue pregnancy should be treated with targeted PAH therapies including prostacyclin analogues and/or phosphodiesterase type 5 inhibitors. The care of the pregnant women with PAH requires a planned, multidisciplinary approach, preferably in a dedicated pulmonary hypertension referral center, focusing on close monitoring before, during and after delivery.

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Critical arrhythmia associated with pulmonary artery catheterization in a parturient with severe pulmonary hypertension

Cited by 10 publications

References 5 publications

Cardiac arrhythmias related to continuous thermodilution cardiac output measurement in an anaesthetized sheep

Cardiac arrhythmias related to continuous thermodilution cardiac output measurement in an anaesthetized sheep

Anomalous origin of left main coronary artery from pulmonary artery in an adult: Peri-operative concerns

Birth Control and Pregnancy Management in Pulmonary Hypertension

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