Departments of Anesthesia and Pain Medicine, Toronto General Hospital, Toronto, Ontario, Canada.
Anesth Analg. 2010 Feb 1;110(2):365-9. doi: 10.1213/ANE.0b013e3181c6bbf0. Epub 2009 Nov 21.
Acute pulmonary hypertension is a severe and life-threatening reaction that rarely occurs secondary to protamine administration. Management of systemic hypotension combined with severe pulmonary hypertension causing right ventricular failure is challenging. We describe a case of acute pulmonary hypertension induced by protamine during elective coronary artery bypass surgery refractory to multiple systemic inotropic and vasopressor therapies. After inhaled prostacyclin administration, our patient's pulmonary artery pressures decreased from 70/37 to 45/23 mm Hg within 10 min. The case highlights a role for inhaled nebulized prostacyclin as a selective pulmonary vasodilator with minimal systemic hypotensive effects.
急性肺动脉高压是一种严重且危及生命的反应，很少由鱼精蛋白给药引起。管理全身低血压合并严重肺动脉高压导致右心衰竭具有挑战性。我们描述了一例在择期冠状动脉旁路手术中由鱼精蛋白引起的急性肺动脉高压的病例，该病例对多种全身正性肌力和血管加压药物治疗均无反应。吸入前列环素后，我们的患者肺动脉压在 10 分钟内从 70/37 降至 45/23mmHg。该病例强调了吸入雾化前列环素作为一种选择性肺动脉扩张剂的作用，其对全身低血压的影响最小。
