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Canadian Journal of Anesthesia, Vol 40, 515-517, Copyright © 1993 by Canadian Anesthesiologists' Society

ARTICLES

Blunt cardiac injury and intraoperative hypoxaemia

G Kantor and JH Devitt
Department of Anaesthesia, Sunnybrook Health Science Centre, University of Toronto, Ontario.

A 28-yr-old man sustained blunt chest trauma in a motor vehicle accident. Severe intraoperative hypoxaemia occurred, unresponsive to oxygen and positive expiratory pressure therapy. Trans-oesophageal echocardiography revealed myocardial contusion and tricuspid valve rupture. Dobutamine improved left ventricular function and ejection fraction resulting in an immediate improvement in arterial oxygenation and saturation. Tricuspid injury and the diagnosis of myocardial contusion are discussed. The case highlights the importance of a non-pulmonary mechanism of hypoxaemia.




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Copyright © 1993 by the Canadian Anesthesiologists' Society.