High-output left ventricular failure after dextran use in an operative hysteroscopy.
High-output left ventricular failure occurred in a patient after a difficult case of hysteroscopic lysis of adhesions using dextran as a distension medium. The excessive dissection in the uterine wall, the long duration of the operation, and the large volumes of dextran probably caused intravasation of dextran into the systemic circulation inducing a significant shift of fluids from the third space. This was possibly assisted by the large volume of fluids given intravenously in a 45-kg patient initiating the reported sequence of events.
Department of Obstetrics and Gynecology, Assaf Harofeh Medical Center, Sackler School of Medicine, Tel Aviv University, Israel.
A
A
Golan
M
M
Siedner
M
M
Bahar
R
R
Ron-El
A
A
Herman
E
E
Caspi
D000328:Adult; D003911:Dextrans / Q000009:adverse effects*; D005260:Female; D006801:Humans; D015907:Hysteroscopy / Q000009:adverse effects* / Q000379:methods; D000267:Tissue Adhesions / Q000601:surgery; D014591:Uterine Diseases / Q000601:surgery; D016277:Ventricular Function, Left / Q000187:drug effects* / Q000502:physiology
D003911:Dextrans