Balancing Hemodynamics in the Management of Sepsis and Cor Pulmonale
57y.o male with history of pulmonary hypertension with cor pulmonale, pAfib, interstitial lung disease, diaphragmatic paresis, CAD, and COPD on 7L O2 who presented with polymicrobial septicemia, CHF exacerbation, and acute on chronic hypoxemic respiratory failure. Antibiotics started and gentle diuresis initiated for right-heart optimization. On day 7, patient developed acutely worsening hypoxemia and was admitted to the MICU on BiPAP. After failing NIPPV onICU day 2, patient was intubated and immediately developed signs of cardiogenic shock not amenable to vasopressors, he acutely expired the same night. We will discuss the interplay of managing sepsis, cor pulmonale, and respiratory insufficiency.
Lau S, Maheshwari N, Asbahi MF. Balancing hemodynamics in the management of sepsis and cor pulmonale. Paper presented at: The American Society of Anesthesiology Annual Meeting; 2021 Oct 8-12; San Diego, CA. Available at: https://www.abstractsonline.com/pp8/#!/9323/presentation/5501