A 69-year-old patient underwent hepatic lobectomy.
Monitoring included electrocardiography, arterial line, central venous pressure (CVP), urinary catheter, and TEE.
Surgery was performed without incidents.
30. After resection and with satisfactory hemostasis, the patient presented progressive decrease in blood pressure (BP) to 50 mmHg in systolic pressure, with heart rate (HR) 80 per minute, CVP 4 mmHg, Sat 02 99%,02 C
The TEE showed normal filling and left ventricular motility and no passage of embolic material through the right cavities or evidence of overload of these.
Anaphylaxis was postulated, starting treatment with 300 mg hydrolytical effects PA and volume replacement 0.25 mg intravenous, followed by infusion up to 0.3 mg/kg/min HR, without obtaining 0.5 mg intravenous.
Noradrenaline up to 3 mg/kg/min was added without response.
At the same time, a pulmonary artery catheter (CAP) was installed, which showed a pulmonary artery pressure (PAP) of 22/10 mmHg, pulmonary capillary pressure (PCP) 8 mmHg, vascular index L5.45/SI/egum
Once surgery was performed, the patient was managed conservatively, with gradual recovery of BP and a decrease in the requirements for eosinefrin deficiency.
She stopped at 4 hours without problems.
