ABSTRACT
As a stress-induced disease, takotsubo cardiomyopathy can also occur in septic syndromes; however, the hemodynamic management is fundamentally different from the treatment approaches for classical septic cardiomyopathy, as beta mimetics can increase the heart failure symptoms in takotsubo cardiomyopathy. This article reports the case of an 82-year-old female patient who presented with acute abdomen due to adhesion ileus and takotsubo cardiomyopathy, developed severe septic shock with peritonitis and could be successfully hemodynamically stabilized with levosimendan.
Subject(s)
Cardiotonic Agents/therapeutic use , Hydrazones/therapeutic use , Pyridazines/therapeutic use , Shock, Septic/complications , Shock, Septic/drug therapy , Takotsubo Cardiomyopathy/complications , Abdomen, Acute/etiology , Abdomen, Acute/therapy , Aged, 80 and over , Female , Hemodynamics , Humans , Ileus/complications , Peritonitis/complications , Radionuclide Ventriculography , Shock, Septic/diagnosis , Simendan , Takotsubo Cardiomyopathy/diagnosisABSTRACT
Intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC) may have a significant impact on physiological functions and is therefore a special challenge for anesthetists. In the presented case after opening the parietal pleura during subphrenical peritonectomy the HIPEC solution accidentally leaked into the right hemithorax with subsequent pleural effusion of more than 2,000 ml. After extubation the patient presented with acute oxygen desaturation and orthopnea. Following pleural sonography and chest X-ray in the operating theatre and recovery area, a thorax drainage was inserted into the pleural space and ventilation support was provided by non-invasive continuous positive air pressure (CPAP) ventilation. With reference to recent publications the anesthesiological management of patients undergoing HIPEC is presented.
