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Chapter 29 - Embolism

from Section 2 - Cardiac, Thoracic, and Vascular Anesthesia

Published online by Cambridge University Press:  03 August 2023

Jessica A. Lovich-Sapola
Affiliation:
Cleveland Clinic, Ohio
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Summary

A 73-year-old female underwent a repair of an abdominal aortic aneurysm. She has a history of heavy smoking, severe chronic obstructive pulmonary disease (COPD), hypertension (HTN), diabetes mellitus, and is noncompliant with her insulin treatment. Toward the end of the surgery, the patient was transferred to another anesthesia provider, who took her to the post-anesthesia care unit (PACU) intubated, sedated, and with the arterial line and central venous pressure (CVP) monitors in place. Approximately 15 minutes after the patient’s arrival in the PACU, the anesthesiologist was called emergently to see the patient. The patient had become severely hypotensive. After a quick examination, the anesthesiologist noticed that one of the peripheral infusions was placed on an inflated pressure bag and there was no fluid in the bag or in the intravenous (IV) line. What do you think happened? How would you further assess the patient? What is your treatment?

Type
Chapter
Information
Anesthesia Oral Board Review
Knocking Out The Boards
, pp. 124 - 131
Publisher: Cambridge University Press
Print publication year: 2023

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References

Broaddus, VC, Ernst, JD, King, TE, et al. Murray and Nadel’s Textbook of Respiratory Medicine, 7th ed. Philadelphia: Elsevier, 2021, pp. 1101–22.Google Scholar
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Richard, C, Ricome, JL, Rimailho, A, et al. Fatal pulmonary embolism with a normal PaO2. Ann Med Interne (Paris) 1983;134(6):559–62.Google ScholarPubMed
Talbot, M, Schemitsch, EH. Fat embolism syndrome: history, definition, epidemiology. Injury 2006;37(Suppl. 4):S3S7.CrossRefGoogle ScholarPubMed
Yao, F-SF, Hemmings, HC, Malhotra, V, et al. Yao and Artusio’s Anesthesiology: Problem-Oriented Patient Management, 9th ed. Alphen aan den Rijn: Wolters Kluwer, 2021, pp. 401–2, 410, 575–7, 605–6.Google Scholar

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