Intraoperative pulseless electrical activity and acute cardiogenic shock after administration of phenylephrine, epinephrine, and ketamine.
نویسندگان
چکیده
The use of phenylephrine has been well described as a potential cause of morbidity and mortality. A thorough literature review of phenylephrine use is presented in this article. The use of ketamine and epinephrine with phenylephrine can precipitate an even more potentially lethal and catastrophic syndrome. We present the case of a 21-year-old man with Hodgkin's lymphoma and lupus who experienced an abrupt hypertensive crisis followed by pulseless electrical activity and cardiogenic shock after application of 2.5% phenylephrine-soaked nasal pledgets prior to excision of a large nasopharyngeal tumor. This case report adds to the current literature on the potential dangers of phenylephrine in clinical practice and describes a case of reversible severe left ventricular dysfunction in the setting of excessive pharmacologically induced sympathetic stimulation.
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متن کاملComment on Grmec et al.: A treatment protocol including vasopressin and hydroxyethyl starch solution is associated with increased rate of return of spontaneous circulation in blunt trauma patients with pulseless electrical activity
Dear Editor, The study by Grmec et al. is encouraging given the very high mortality of trauma victims who experience out-ofhospital pulseless electrical activity (PEA) arrest [1, 2]. In the treatment group there were three interventions: vasopressin, hypertonic saline and hydroxyethyl starch (hypertonic hydroxyethyl starch in the study). However, caution is to be advocated in the use of hydroxy...
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عنوان ژورنال:
- The Ochsner journal
دوره 10 3 شماره
صفحات -
تاریخ انتشار 2010