Anesth Pain Med.  2014 Apr;9(2):123-127.

Severe acute respiratory failure after aortic valve replacement in a patient with nonspecific interstitial pneumonia: A case report

• Seo M
• Lee EH
• Sim JY

Abstract

A 57-year-old female patient with suspicious interstitial lung disease underwent aortic valvular replacement for aortic stenosis. She complained of severe dyspnea, and her preoperative chest X-ray and computed tomography findings showed multiple ground glass opacity causing interstitial lung disease. After aortic valvular replacement, and as part of the weaning process after cardiopulmonary bypass, she was placed on a ventilator. Nonetheless, the peak airway pressure was higher than 40 mmHg with a less than 50 ml tidal volume, and there was no visible end-tidal CO2 curve. Repeated suction, expansion, and intravenous corticosteroid injection with aminophylline loading were performed to improve the patient's condition. Extracorporeal membrane oxygenation began after cardiopulmonary bypass and was sustained for 5 days. This case demonstrated the fragility of lungs with interstitial disease, and the need to exercise more precaution against acute respiratory failure after cardiopulmonary bypass.

Keyword

Acute respiratory failure; Cardiopulmonary bypass; Interstitial lung disease

MeSH Terms

Aminophylline
Aortic Valve Stenosis
Aortic Valve*
Cardiopulmonary Bypass
Dyspnea
Extracorporeal Membrane Oxygenation
Female
Glass
Humans
Lung
Lung Diseases, Interstitial*
Middle Aged
Respiratory Insufficiency*
Suction
Thorax
Tidal Volume
Ventilators, Mechanical
Weaning
Aminophylline