Severe acute respiratory failure after aortic valve replacement in a patient with nonspecific interstitial pneumonia: A case report.
- Author:
Misook SEO
1
;
Eun Ho LEE
;
Ji Yeon SIM
Author Information
1. Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. jysim@amc.seoul.kr
- Publication Type:Case Report
- Keywords:
Acute respiratory failure;
Cardiopulmonary bypass;
Interstitial lung disease
- MeSH:
Aminophylline;
Aortic Valve Stenosis;
Aortic Valve*;
Cardiopulmonary Bypass;
Dyspnea;
Extracorporeal Membrane Oxygenation;
Female;
Glass;
Humans;
Lung;
Lung Diseases, Interstitial*;
Middle Aged;
Respiratory Insufficiency*;
Suction;
Thorax;
Tidal Volume;
Ventilators, Mechanical;
Weaning
- From:Anesthesia and Pain Medicine
2014;9(2):123-127
- CountryRepublic of Korea
- Language:English
-
Abstract:
A 57-year-old female patient with suspicious interstitial lung disease underwent aortic valvular replacement for aortic stenosis. She complained of severe dyspnea, and her preoperative chest X-ray and computed tomography findings showed multiple ground glass opacity causing interstitial lung disease. After aortic valvular replacement, and as part of the weaning process after cardiopulmonary bypass, she was placed on a ventilator. Nonetheless, the peak airway pressure was higher than 40 mmHg with a less than 50 ml tidal volume, and there was no visible end-tidal CO2 curve. Repeated suction, expansion, and intravenous corticosteroid injection with aminophylline loading were performed to improve the patient's condition. Extracorporeal membrane oxygenation began after cardiopulmonary bypass and was sustained for 5 days. This case demonstrated the fragility of lungs with interstitial disease, and the need to exercise more precaution against acute respiratory failure after cardiopulmonary bypass.
