[Looking for the reason of hemodynamic instability: a case report of the role of intraoperative ultrasound].

Buscando o motivo da instabilidade hemodinâmica: relato de caso sobre o papel do ultrassom intraoperatório.
Acidente de trânsito Cardiac tamponade Echocardiography Ecocardiografia Intraoperative monitoring Monitoração intraoperatória Tamponamento cardíaco Traffic accident

Journal

Brazilian journal of anesthesiology (Elsevier)
ISSN: 2352-2291
Titre abrégé: Braz J Anesthesiol
Pays: Brazil
ID NLM: 101624623

Informations de publication

Date de publication:
Historique:
received: 15 05 2018
revised: 10 08 2018
accepted: 04 09 2018
pubmed: 18 1 2019
medline: 29 8 2019
entrez: 18 1 2019
Statut: ppublish

Résumé

A prompt and effective management of trauma patient is necessary. The aim of this case report is to highlight the importance of intraoperative echocardiography as a useful tool in patients suffering from refractory hemodynamic instability no otherwise explained. A 41 year-old woman suffered a car accident. At the emergency department, no abnormalities were found in ECG or chest X-ray. Abdominal ultrasound revealed the presence of abdominal free liquid and the patient was submitted to urgent exploratory laparotomy. Nevertheless, she persisted suffering arterial hypotension and metabolic acidosis. Looking for the reason of her hemodynamic instability, intraoperative transthoracic echocardiography was performed, finding out the presence of pericardial effusion. Once the cardiac surgeon extracted pericardial clots, patient's situation improved clinically and analytically. Every anesthesiologist should be able to use the intraoperative echocardiography as an effective tool in order to establish the appropriate measures to promote the survival of patients suffering severe trauma.

Sections du résumé

BACKGROUND AND OBJECTIVES OBJECTIVE
A prompt and effective management of trauma patient is necessary. The aim of this case report is to highlight the importance of intraoperative echocardiography as a useful tool in patients suffering from refractory hemodynamic instability no otherwise explained.
CASE REPORT METHODS
A 41 year-old woman suffered a car accident. At the emergency department, no abnormalities were found in ECG or chest X-ray. Abdominal ultrasound revealed the presence of abdominal free liquid and the patient was submitted to urgent exploratory laparotomy. Nevertheless, she persisted suffering arterial hypotension and metabolic acidosis. Looking for the reason of her hemodynamic instability, intraoperative transthoracic echocardiography was performed, finding out the presence of pericardial effusion. Once the cardiac surgeon extracted pericardial clots, patient's situation improved clinically and analytically.
CONCLUSION CONCLUSIONS
Every anesthesiologist should be able to use the intraoperative echocardiography as an effective tool in order to establish the appropriate measures to promote the survival of patients suffering severe trauma.

Identifiants

pubmed: 30651202
pii: S0034-7094(18)30229-0
doi: 10.1016/j.bjan.2018.09.012
pmc: PMC9391855
pii:
doi:

Types de publication

Case Reports Journal Article

Langues

por

Sous-ensembles de citation

IM

Pagination

200-203

Informations de copyright

Copyright © 2018 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

Références

Am J Surg. 2018 Apr;215(4):727-734
pubmed: 29397887
J Crit Care. 2017 Apr;38:144-151
pubmed: 27907878
Emerg Med Clin North Am. 2015 Aug;33(3):519-27
pubmed: 26226863
J Trauma. 2009 Oct;67(4):788-91
pubmed: 19680160
Anesth Analg. 2016 Jun;122(6):1794-804
pubmed: 27195630

Auteurs

Ángel Becerra (Á)

Hospital Universitario de Gran Canaria Dr. Negrín, Department of Anesthesiology, Las Palmas de Gran Canaria, Espanha. Electronic address: angbecbol@gmail.com.

Héctor Trujillo (H)

Hospital Universitario de Gran Canaria Dr. Negrín, Department of Anesthesiology, Las Palmas de Gran Canaria, Espanha.

Lucía Valencia (L)

Hospital Universitario de Gran Canaria Dr. Negrín, Department of Anesthesiology, Las Palmas de Gran Canaria, Espanha.

Aurelio Rodríguez-Pérez (A)

Hospital Universitario de Gran Canaria Dr. Negrín, Department of Anesthesiology, Las Palmas de Gran Canaria, Espanha; Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Espanha.

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Classifications MeSH