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首页> 外文期刊>BMC Anesthesiology >Sudden hypoxemia after uneventful laparoscopic cholecystectomy: another form of SAM presentation
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Sudden hypoxemia after uneventful laparoscopic cholecystectomy: another form of SAM presentation

机译：经腹腔镜胆囊切除术后突然低氧血症：SAM表现的另一种形式

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Background Perioperative dynamic left ventricular outflow obstruction associated with systolic anterior motion of the mitral valve is well recognized as a cause for unexplained sudden hypotension in perioperative settings, even without underlying heart diseases such as hypertrophic obstructive cardiomyopathy. We treated a patient who experienced sudden hypoxemia without severe hypotension during emergence from anesthesia after an uneventful laparoscopic cholecystectomy. Case presentation A 65-year-old female patient with a history of hypertension presented a sudden decrease in oxygen saturation to 80% after an uneventful cholecystectomy. Although a portable chest radiograph showed bilateral hilar pulmonary infiltrates consistent with pulmonary edema, we explored the underlying cause, i.e., systolic anterior motion of the mitral valve and left ventricular outflow tract obstruction with bedside transthoracic echocardiography. We speculate that dynamic mitral regurgitation resulted in pulmonary edema and, thereby, hypoxemia in this case without severe hypotension. Conclusions Careful bedside examination with transthoracic echocardiography was useful in making diagnosis and in guiding appropriate therapy for this patient. Clinicians should be aware that systolic anterior motion of the mitral valve may present as unexplained sudden hypoxemia in the perioperative setting.
机译：背景与二尖瓣收缩前运动相关的围术期动态左心室流出道阻塞被公认为是围手术期无法解释的突然低血压的原因，即使没有潜在的心脏病如肥厚性梗阻性心肌病。我们对一名患者进行了一次顺利的低氧血症，在无痛的腹腔镜胆囊切除术后出现麻醉期间没有严重的低血压。病例介绍一位有高血压病史的65岁女性患者在进行了无害的胆囊切除术后氧饱和度突然下降至80％。尽管便携式胸片显示双侧肺门肺部浸润与肺水肿一致，但我们探讨了根本原因，即二尖瓣的收缩前运动和床旁经胸超声心动图检查左室流出道梗阻。我们推测动态二尖瓣反流会导致肺水肿，从而在这种情况下发生低氧血症而不会引起严重的低血压。结论经胸腔超声心动图仔细的床旁检查有助于诊断和指导该患者的适当治疗。临床医生应注意，围手术期二尖瓣收缩前运动可能表现为无法解释的突然低氧血症。

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