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A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care

Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
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Minerva Anestesiologica 2001 January-February;67(1-2):79-84

language: English

Norepinephrine can be useful for the treatment of right ventricular failure combined with acute pulmonary hypertension and systemic hypotension. A case report

Bertolissi M., Bassi F., Da Broi U.

From the Second Department of Anesthesia and ICU Azienda Ospedaliera S. Maria della Misericordia Udine, Italy


A 48-­year-old wom­an who under­went emer­gen­cy car­diac sur­gery for remov­al of a throm­bus par­tial­ly occlud­ing the ­mitral ­valve, devel­oped pul­mo­nary hyper­ten­sion ­right ven­tric­u­lar fail­ure and system­ic hypo­ten­sion, in the imme­di­ate post­op­er­a­tive peri­od, a clin­i­cal con­di­tion not ­well con­trolled by ­high dos­es of epi­neph­rine and dobu­ta­mine. The addi­tion of a con­tin­u­ous infu­sion of nor­epi­neph­rine in incre­men­tal dos­ag­es, ­caused the ­rise in car­diac ­index accom­pa­nied ­before by the reduc­tion in the pul­mo­nary pres­sure and the stabil­ity in the system­ic pres­sure, ­than by the fur­ther reduc­tion in the pul­mo­nary pres­sure and the ­increase in the system­ic pres­sure. The con­clu­sion is ­drawn ­that nor­epi­neph­rine is use­ful in the treat­ment of ­right ven­tric­u­lar fail­ure ­which fol­lows a con­di­tion of ­acute pul­mo­nary hyper­ten­sion, ­because the improve­ment of car­diac per­for­mance estab­lished with­out ­adverse ­effects on the pul­mo­nary pres­sures ­whose val­ues on the con­trary pro­gres­sive­ly ­declined.

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