Anesthetic management of a patient with pulmonary hypertension due to a large anterior mediastinal tumor anticipated by preoperative computed tomography

A 74-year-old man underwent an operation for an extremely large mediastinal tumor. Despite the lack of respiratory difficulty or distention of the jugular veins, preoperative computed tomography showed suppression of the left atrium by the huge tumor. We suspected pulmonary hypertension and monitore...

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Bibliographic Details
Published inMasui. The Japanese journal of anesthesiology Vol. 61; no. 2; p. 202
Main Authors Komasawa, Nobuyasu, Noma, Hideki, Sugi, Takashi, Sukenaga, Norihiko, Tokuoka, Takane, Kakiuchi, Hideki
Format Journal Article
LanguageJapanese
Published Japan 01.02.2012
Subjects
Aged
Alprostadil - administration & dosage
Anesthesia, General
Humans
Hypertension, Pulmonary - diagnostic imaging
Hypertension, Pulmonary - etiology
Imidazoles - administration & dosage
Male
Mediastinal Neoplasms - complications
Mediastinal Neoplasms - surgery
Perioperative Care
Pyridones - administration & dosage
Tomography, X-Ray Computed
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Summary:A 74-year-old man underwent an operation for an extremely large mediastinal tumor. Despite the lack of respiratory difficulty or distention of the jugular veins, preoperative computed tomography showed suppression of the left atrium by the huge tumor. We suspected pulmonary hypertension and monitored continuously with a pulmonary catheter. The Pp/Ps ratio decreased gradually from 0.8 to 0.7 by continuous administration of alprostadil or olprinone. After tumor resection, the Pp/Ps ratio was reduced and maintained at 0.2 even after alprostadil and olprinone administration was discontinued. The tumor was considered to have caused the severe pulmonary hypertension, as anticipated from the preoperative CT.
ISSN:0021-4892