Cure of Refractory Hypotension in a Hemodialysis Patient
نویسندگان
چکیده
We present a case of 67-year-old male with end-stage renal disease (ESRD) on hemodialysis who was admitted to the hospital after recurrent falls secondary postural hypotension. He not able tolerate fluid removal dialysis due persistent hypotension despite maximal doses midodrine and developed severe edema. A right heart catheterization revealed raised biventricular filling pressure consistent failure low systemic vascular resistance pulmonary hypertension. Duplex ultrasound left arm cephalic arteriovenous fistula (AVF) blood flow 5.6 L/min. hypothesized cause his high output from an AV lack increase in compression AVF. The AVF ligated tunneled catheter placed. Immediately ligation, patient without hypotension, leading significant improvement edema shortness breath. This highlights potential adverse cardiovascular effects salutary ligation appropriate clinical settings.
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ژورنال
عنوان ژورنال: Cureus
سال: 2023
ISSN: ['2168-8184']
DOI: https://doi.org/10.7759/cureus.41942