Management of a patient with severe pulmonary hypertension for urgent orthopaedic surgery
Keywords:Functional status assessment, Geriatric patient, Right ventricular failure, Severe pulmonary hypertension, Systemic vascular resistance, Urgent orthopaedic surgery
Pulmonary hypertension represents an important risk factor for increased peri-operative morbidity and mortality. Although pulmonary hypertension is a rare disease, there are special considerations to the anesthetic management in patients with severe pulmonary hypertension. Anesthetic aims in pulmonary hypertension are to avoid increased pulmonary vascular resistance, to avoid marked decrease in venous return or systemic vascular resistance, to avoid myocardial depression and to maintain normal heart rate. We present a case of 85 year old male patient having severe pulmonary hypertension, with reported pulmonary artery pressure of 72 mmHg, posted for proximal femoral nailing. We want to stress on the importance of pre-operative evaluation and careful anesthesia planning for successful peri-operative and post-operative outcomes.
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