Affiliation:
1. Department of Anesthesiology, West China Hospital, Sichuan University and West China Research Unit, Chinese Academy of Medical Sciences, Chengdu, China
Abstract
Pulmonary arterial pressure (PAH) usually increases after cardiopulmonary bypass (CPB), but this normally does not affect weaning off CPB. Here we report a case of severe PAH in a patient with normal left atrial pressure. Prolonging CPB by 45 min did not lead to lower PAH. Given that lung injury can stimulate secretion of vasoconstrictors that trigger PAH, we decided to gradually increase blood flow into the lungs in an effort to restore the balance between pulmonary vasoconstrictors and vasodilators. Pulmonary artery pressure gradually decreased, allowing the patient to be weaned off CPB, after which she recovered uneventfully. Our experience suggests an approach for managing acute, severe PAH after CPB without the need for mechanical circulatory support.
Funder
Natural Science Foundation of Sichuan Province
1•3•5 Project for Disciplines of Excellence from West China Hospital, Sichuan University
Subject
Advanced and Specialized Nursing,Cardiology and Cardiovascular Medicine,Safety Research,Radiology, Nuclear Medicine and imaging,General Medicine