Acute hemodynamic collapse after induction of general anesthesia for emergent pulmonary embolectomy

Anesthesia and Analgesia
Peter RosenbergerHolger K Eltzschig

Abstract

Patients undergoing pulmonary embolectomy often experience hemodynamic deterioration during induction of general anesthesia (GA). Therefore, we studied the incidence and possible risk factors for hemodynamic deterioration during GA induction. Fifty-two consecutive patients undergoing emergent pulmonary embolectomy at our institution were included. Hemodynamic collapse after GA induction was defined as hypotension refractory to vasopressor, inotrope, or fluid administration, requiring cardiopulmonary resuscitation followed by urgent institution of cardiopulmonary bypass (CPB). Demographic variables, comorbidities, specific location of thromboemboli, preoperative inotropic support, and anesthetic drugs used for GA induction were evaluated as possible risk factors. After GA induction, hemodynamic collapse occurred in 19% of patients (n = 10). However, the occurrence of hemodynamic instability was not predicted by any of the evaluated risk factors. In addition, the incidence of in-hospital mortality did not differ between hemodynamically stable or unstable patients (10%; 4 of 42 versus 10%; 1 of 10 patients, respectively). In conclusion, hemodynamic deterioration after GA induction develops frequently during emergent pulmonary embo...Continue Reading

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Citations

May 26, 2009·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Alana M FlexmanStephan K W Schwarz
Nov 16, 2011·Critical Care Clinics·Kenneth E Wood
Apr 1, 2008·Journal of Cardiothoracic and Vascular Anesthesia·Neel AminMary Arthur
Dec 30, 2014·Journal of Clinical Anesthesia·Jeremy M BennettSusan S Eagle
Oct 17, 2017·Anesthesiology·Sandeep Khanna, Anand Mehta
Feb 22, 2007·Anesthesia and Analgesia·Stephen T Webb, Joseph E Arrowsmith
Jul 15, 2020·Seminars in Cardiothoracic and Vascular Anesthesia·Al-Awwab M Dabaliz, Faisal D Arain
Mar 4, 2017·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Matthew A WarnerRochelle J Molitor
Feb 17, 2021·Seminars in Respiratory and Critical Care Medicine·John L MurrayWilliam B Keeling
Sep 29, 2020·Emergency Medicine Clinics of North America·Samuel Francis, Christopher Kabrhel

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