Anaesthetic management of a patient with Eisenmenger syndrome and [beta]-thalassemia major for splenectomy

We describe for the first time, the perioperative care of a patient with a rare combination of Eisenmenger syndrome with β-thalassemia major presenting for splenectomy. Patients with Eisenmenger syndrome have polycythemia because of chronic hypoxia but our patient was anaemic and had thrombocytopeni...

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Bibliographic Details
Published in:Indian journal of anaesthesia 2011-03, Vol.55 (2), p.187
Main Authors: Gupta, Nishkarsh, Kaur, Sarbjot, Goila, Ajay, Pawar, Mridula
Format: Article
Language:English
Subjects:
Anesthetics
Blood pressure
Care and treatment
Dosage and administration
Heart diseases
Hypertension
Nursing
Patient outcomes
Pulmonary arteries
Splenectomy
Thalassemia
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Summary:We describe for the first time, the perioperative care of a patient with a rare combination of Eisenmenger syndrome with β-thalassemia major presenting for splenectomy. Patients with Eisenmenger syndrome have polycythemia because of chronic hypoxia but our patient was anaemic and had thrombocytopenia because of thalassemia major. The management of such a case can be challenging for any anaesthesiologist because of severe V/Q mismatch (high shunt fraction and restrictive lung disease because of hypersplenism), decreased oxygen carrying capacity (anaemia) and increased risk of haemorrhage (thrombocytopenia), along with the potential increase in intracardiac shunt during anaesthesia.
ISSN:0019-5049
0976-2817
DOI:10.4103/0019-5049.79892