Intraoperative cardiac arrest: was it the ACE inhibitor?
Continuing renin-angiotensin-aldosterone system antagonist therapy on the day of surgery is controversial, and appears to contribute to intraoperative hypotension. A patient presenting for cerebral aneurysm clipping continued her angiotensin-converting enzyme inhibitor on the morning of surgery, and subsequently experienced significant postinduction hypotension that culminated in cardiac arrest. Following successful resuscitation, she returned 6 weeks later to have her aneurysm clipped using identical anesthetic management; her blood pressure medications were held on the day of surgery.
Department of Anesthesia, Stanford University School of Medicine, Stanford, CA 94305, USA.
Jens
J
Bjerregaard
Department of Anesthesia, Stanford University School of Medicine, Stanford, CA 94305, USA. Electronic address: rajaffe@stanford.edu.
Richard A
RA
Jaffe
D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000009:adverse effects*; D016887:Cardiopulmonary Resuscitation / Q000379:methods; D005260:Female; D006323:Heart Arrest / Q000139:chemically induced* / Q000150:complications / Q000628:therapy; D006801:Humans; D007022:Hypotension / Q000139:chemically induced / Q000150:complications; D002532:Intracranial Aneurysm / Q000601:surgery; D007431:Intraoperative Complications / Q000139:chemically induced*; D017706:Lisinopril / Q000009:adverse effects*
D000806:Angiotensin-Converting Enzyme Inhibitors; D017706:Lisinopril
ACE inhibitor; Angiotensin-converting enzyme (ACE); Cardiac arrest intraoperative; Renin-angiotensin-aldosterone system antagonist