Norepinephrine
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No response: case report A 51-year-old woman exhibited no response during treatment with norepinephrine for decreasing BP. The woman with malignant liver tumour, was scheduled to undergo a surgical procedure. Her medical history was significant for only hypertension, for which she was not on any regular medications. Prior to the procedure, various examinations were performed, which showed normal results. After induction of unspecified general anaesthesia, she was ventilated with 100% oxygen at a tidal volume of 450mL. During the procedure, exploration showed that the tumour was primarily located in Couinaud’s segment IV and involved the post-hepatic inferior vena cava. Hence, left hemihepatectomy was performed, including the junction between the anterior wall of the inferior vena cava and the middle and left hepatic veins. However, shortly after the inferior vena cava was opened, her BP and differential pressure dropped, and her central venous pressure markedly increased. Examinations showed sinus tachycardia. Therefore, she was administered a total of 2mg IV norepinephrine in separate doses; however, her BP did not respond and continued to decrease. Later, she received epinephrine along with cardiopulmonary resuscitation and emergency cardiac compression. After her haemodynamic condition improved, examinations showed that an incorrect suture placed between the pericardium and the inferior vena cava led to the development of cardiac tamponade. The large haemopericardium was evacuated, and she was shifted to the ICU. Six days later, she was discharged in a good condition. Wang J-W, et al. Ultrasound-assisted diagnosis of intraoperative cardiac tamponade during hemihepatectomy: a case report. Journal of International Medical Research 48: No. 803508278 8, Jan 2020. Available from: URL: http://doi.org/10.1177/0300060520945895
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Reactions 17 Oct 2020 No. 1826
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