Anesthetic Management for Resection of a Pulmonary Arteriovenous Malformation.
10.4097/kjae.2001.40.1.100
- Author:
Woon Seok ROH
1
;
Seok Young SONG
;
Chan Hong PARK
;
Bong Il KIM
;
Soung Kyung CHO
;
Sang Hwa LEE
;
Sub LEE
;
Wook Su AHN
Author Information
1. Department of Anesthesiology, School of Medicine, Taegu Catholic University, Taegu, Korea.
- Publication Type:Original Article
- Keywords:
Lung: pulmonary arteriovenous malformation;
Ventilation: one lung;
hypoxemia;
intra pulmonary shunt
- MeSH:
Adult;
Anoxia;
Arteriovenous Malformations*;
Blood Gas Analysis;
Embolism, Paradoxical;
Female;
Hemorrhage;
Humans;
One-Lung Ventilation;
Oxygen;
Pulmonary Artery;
Reference Values;
Vascular Resistance;
Veins
- From:Korean Journal of Anesthesiology
2001;40(1):100-105
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Pulmonary arteriovenous malformation (PAVM) is an uncommon congenital anomaly. As PAVM is a direct communication between branches of the pulmonary artery and vein, severe hypoxemia, paradoxical embolism, and massive hemorrhage can result. We present a 39-year-old woman with severe hypoxemia after the induction of one lung ventilation (OLV) for resection of a PAVM in her right lower lobe. We analyzed the cause of hypoxemia by an arterial blood gas analysis and estimated shunt equation. The preoperative value of an intrapulmonary shunt (Qs/Qt) was 15%. However, after the OLV, the values of Qs/Qt increased to 48% with 92.1% arterial oxygen saturation (SaO2). After the resection of PAVM, the value of Qs/Qt decreased to 36% during the OLV, and postoperative value of Qs/Qt and SaO2 were in the normal range. These findings represent that PAVM patients are prone to severe hypoxemia and an abnormally high Qs/Qt, which might be induced by the increase of pulmonary vascular resistance during OLV.
