Anaesthesia for a non cardiac surgery in a patient with an Eisenmenger syndrome. Interest of a non invasive haemodynamic monitoring

Annales Françaises D'anesthèsie Et De Rèanimation
M L GuyeR Muchada

Abstract

Patients with an Eisenmenger syndrome have an instuble hemodynamic status. During a general anaesthesia, the intracardiac shunt has to maintain the correct orientation and volume, adapted to each patient, in such a condition, to avoid the risk of hypoxemia and cardiac failure. The haemodynamic monitoring with a Swan Ganz catheter could be useful. But it is necessary to evaluate the advantage and the risks when the technique is used in these pathological circumstances. Moreover, when the cardiac output is measured with the thermodilution technique, the right-left intra cardiac shunt volume, is not taking into account. The continuous haemodynamic monitoring, with a simplified transoesophageal echo-Doppler system, as it was done in this case, allows appreciate the real quantitative variations of the shunt. In this way the more adequate calculation of some others haemodynamic parameters, over all the total systemic vascular resistances, allows a more precise therapeutic approach.

References

Nov 1, 1965·The American Journal of Cardiology·J I Hoffman, A M Rudolph
Dec 16, 1998·Annals of Internal Medicine·W VongpatanasinR A Lange
Feb 6, 1999·Journal of the American College of Cardiology·N M AmmashC A Warnes
Oct 10, 2002·Regional Anesthesia and Pain Medicine·John T MartinJoseph F Antognini
Nov 19, 2002·Current Opinion in Pediatrics·Taosheng Huang
Jun 23, 2009·Archives de pédiatrie : organe officiel de la Sociéte française de pédiatrie·D Bonnet

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