Massive hemoptysis during monitored anesthesia care for esophagogastroduodenoscopy with percutaneous endoscopic gastrostomy tube placement: a case report.
Although rare, hemoptysis is a frightening and potentially life-threatening complication of cystic fibrosis (CF) that may occur during anesthesia. Anesthesia providers should be aware of the complication and know how to promptly and effectively manage it if encountered. This case illustrates the effects of hemoptysis during anesthesia on a patient with an already compromised pulmonary status. A 26-year-old patient experienced massive hemoptysis during monitored anesthesia care for an esophagogastroduodenoscopy with percutaneous endoscopic gastrostomy tube placement. The patient's hemoglobin saturation with oxygen fell from a percentage in the low 90s to less than 10% within seconds after placement of the scope. The patient was found to have bleeding from the right bronchial artery that was subsequently embolized. emoptysis is a rare occurrence during moni-CF involves many organ systems, most notably the respiratory system. As the disease progresses, frequent infections and inflammation initiate destruction of the parenchyma leading to chronic obstruction of the airways. Hemoptyis, along with pneumothorax and bronchospasm (reactive airway), are a few potential complications of significance in anesthesia. Increased survival rates create a greater likelihood that patients with CF will be candidates for procedures requiring anesthesia. An understanding of the pathophysiology of the disease, as well as its anesthetic implications and management, is imperative in order to safely administer anesthesia in this population.
University of Kansas Medical Center, USA. mwiehe@kumc.edu
Melissa
M
Wiehe
D000328:Adult; D000768:Anesthesia, General / Q000009:adverse effects*; D003550:Cystic Fibrosis / Q000150:complications*; D016145:Endoscopy, Digestive System; D005260:Female; D005774:Gastrostomy; D006469:Hemoptysis / Q000209:etiology*; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology*; D007441:Intubation, Gastrointestinal