| Use of Emergency Venoarterial Bypass for the Treatment of Acute Pulmonary Edema during Liver Transplantation: A case report. |
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Chul Woo Jung, Mi Geum Lee, Ji Yeon Jeong, Kook Hyun Lee |
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Department of Anesthesiology, Seoul National University College of Medicine, Seoul, Korea. leekh@plaza.snu.ac.kr |
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| Abstract |
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Liver transplantation surgery always has a risk of massive bleeding because of underlying coagulopathy and multiple collateral vessels in end-stage liver disease patients.
Moreover it adds the risk that operation itself has been done around large arteries and veins connected to the liver.
Therefore anesthesiologists must prepare large bored central venous lines and transfusion materials for massive hemorrhage. Massive hemorrhage itself during liver transplantation is a life threatening condition and it causes complication like secondary pulmonary edema, which will be very fetal if it does not respond to classical treatment. Therefore the hemorrhagic situation must be monitored continuously and treated properly. We report this case because the authors experienced massive pulmonary edema right after massive hemorrhage followed by cardiopulmonary resuscitation during liver transplantation and coped with venoarterial (VA) bypass, which improved hypoxia and hypercarbia caused by pulmonary edema. |
| Key Words:
liver transplantation; pulmonary edema; venoarterial bypass |
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