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Postoperative Pulmonary Edema after Lower Thoracic Spinal Tumor Surgery-A Case Report

低位胸椎手術後併發急性肺水腫之病例報告

摘要


心血管不穩定常是脊髓損傷的併發症,尤其是頸椎或高位胸椎受損時。本文,我們報告一位低位胸椎腫瘤術後發生急性肺水腫的病例。推斷原因可能是因術中矯正神經性休克造成之低血壓而給予過量之輸液所造成。因此,謹慎給予輸液以及在必要時給予昇壓劑或強心劑是非常重要的。此外,在此類手術中應考慮應用中央靜脈導管或肺動脈導管等侵入性監測儀器當作評估術中輸液的指引。

並列摘要


Cardiovascular instability is a common manifestation of spinal cord injury, especially if the upper thoracic or cervical spine is involved. Here we report a case of lower thoracic spinal tumor who developed acute pulmonary edema postoperatively at post-anesthesia room following surgery. This might be caused by injudicious fluid administration after trying to correct intraoperative hypotension due to neurogenic shock. Therefore, meticulous calculation in fluid resuscitation together with vasopressors or inotropics support is important in dealing with neurogenic shock. Comprehensive monitoring of hemodynamic parameters, such as with central venous catheter or pulmonary catheter in this sort of surgery should be established for drastic fluid management.

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