Anesthetic Management During an Exploratory Laparotomy
An obese but previously healthy 16-year-old female presented to the ER in DKA. She was sent to the PICU for further management. While there, she became obtunded with down-trending hemoglobin and severe acidosis. She suffered five episodes of cardiopulmonary arrest with ROSC achieved and remained ventilated for 12 hours post-arrest. Emergent bedside exploratory laparotomy was performed due to retroperitoneal hemorrhage secondary to hemorrhagic pancreatitis and traumatic femoral arterial line placement. Withdrawal of care was eventually requested by her guardian given poor prognosis. We discuss the challenges of emergent bedside anesthesia and propose an algorithm for intraoperative resuscitation of hemorrhagic shock.
Ford E, Al-Attar NC, Soto RG. Anesthetic management during an exploratory laparotomy. 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/5845