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Hypertensive Crisis during Removal of Retroperitoneal Mass in a Patient with Undiagnosed Paraganglioma - A Case Report -
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Hee Young Kim, Joo Yun Kim, Hae Kyu Kim, Seung Hoon Baek
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Korean J Crit Care Med. 2013;28(1):64-66.
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DOI: https://doi.org/10.4266/kjccm.2013.28.1.64
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 Abstract
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- Paragangliomas have been reported on multiple locations. A diagnosis of a catecholamine-secreting tumor was considered only after induction of anesthesia, when BP (blood pressure) increased. A 61-year-old male patient was referred for removal of a retroperitoneal mass suspected hemangiopericytoma. He was on medications for hypertension.
There was a surge of ABP (arterial blood pressure) to 186/117 mmHg when the tumor was manipulated at the beginning of the surgery, and this was treated by bolus of diltiazem.
After resection of the tumor, ABP dropped to 57/36 mmHg. In order to improve the patient's hemodynamic parameters, crystalloid fluid was given, and ephedrine was administered intravenously. Persistent hypotension was treated with titrated vasopressors (epinephrine and norepinephrine). When paraganglioma is suspected due to a sudden hypertensive crisis during surgery, the surgeon must decide whether to proceed with the surgical procedure or to stop and restart the surgery after proper management of the crisis.
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Bronchospasm during Minimally Invasive Cardiac Surgery in a Patient with a Mosaic Attenuation Pattern on Lung Computed Tomography: A Case Report
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Eun Soo Kim, Hyeon Jeong Lee, Sung Chun Park, Hee Young Kim, Hyung Gon Je, Jung Min Hong
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Korean J Crit Care Med. 2010;25(1):48-51.
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DOI: https://doi.org/10.4266/kjccm.2010.25.1.48
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Abstract
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- Severe bronchospasm during cardiac surgery is an uncommon, but serious problem. A 52-year-old woman with a mosaic attenuation pattern on the whole lung field was scheduled for repair of an atrial septal defect under minimally invasive cardiac surgery. Bronchospasm developed intraoperatively, but the underlying ventilatory impairment, poor performance of one-lung ventilation and initiation of cardiopulmonary bypass delayed diagnosing and treating the bronchospasm. The bronchospasm induced severe pulmonary edema that required postoperative ventilatory care.
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Citations
Citations to this article as recorded by  - Pulmonary Edema in Severe Bronchospasm
Charles Her
The Korean Journal of Critical Care Medicine.2010; 25(3): 203. CrossRef
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