Norepinephrine can be useful for the treatment of right ventricular failure combined with acute pulmonary hypertension and systemic hypotension. A case report.
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.
Bertolissi
M
M
Second Department of Anesthesia, Azienda Ospedaliera S. Maria della Misericordia, Udine, Italy.
Bassi
F
F
Da Broi
U
U
D000316:Adrenergic alpha-Agonists / Q000627:therapeutic use*; D000328:Adult; D017548:Echocardiography, Transesophageal; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy*; D007022:Hypotension / Q000150:complications / Q000188:drug therapy*; D009638:Norepinephrine / Q000627:therapeutic use*; D018497:Ventricular Dysfunction, Right / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy*
D000316:Adrenergic alpha-Agonists; D009638:Norepinephrine