Torsade de pointes in liver transplantation recipient after induction of general anesthesia: a case report
Korean Journal of Anesthesiology 2014³â 66±Ç 1È£ p.80 ~ p.84
Á¤ÀºÁø(Chung Eun-Jin) - Seoul National University Hospital Department of Anesthesiology and Pain Medicine
ÀüÀ±¼®(Jeon Yun-Seok) - Seoul National University Hospital Department of Anesthesiology and Pain Medicine
±èÇöÁÖ(Kim Hyun-Joo) - Seoul National University Hospital Department of Anesthesiology and Pain Medicine
À̱¹Çö(Lee Kook-Hyun) - Seoul National University Hospital Department of Anesthesiology and Pain Medicine
ÀÌÁö¿ø(Lee Ji-Won) - Seoul National University Hospital Department of Anesthesiology and Pain Medicine
ÇÑ°æ¾Æ(Han Kyoung-Ah) - Seoul National University Hospital Department of Anesthesiology and Pain Medicine
Á¤½Âȯ(Jung Seung-Hwan) - Seoul National University Hospital Department of Anesthesiology and Pain Medicine
Abstract
Torsade de pointes (TdP) is an uncommon and specific form of polymorphic ventricular tachycardia, associated with a prolonged QT interval. Prolongation of the QT interval is the most widely recognized electrophysiological abnormality in patients with liver cirrhosis. We observed a case of TdP leading to cardiopulmonary resuscitation after the induction of general anesthesia, in a patient with liver cirrhosis scheduled for emergency cadaveric donor liver transplantation. The patient had mild QT prolongation on preoperative electrocardiography with a corrected QT (QTc) interval of 455 ms. Drugs used in the preoperative period can elongate cardiac repolarization. Sevoflurane and 5-hydroxytryptamine type 3 receptor antagonists such as palonsetron, used during general anesthesia may have triggered further QT prolongation, producing a fatal condition such as TdP. More caution and consideration in selecting drugs for anesthetic management are necessary for liver cirrhosis patients, especially in patients with preoperative QT prolongation.
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Heart arrest, Liver transplantation, Long QT syndrome, Torsades de pointes
KMID :
0356920140660010080
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