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Acute cardiopulmonary decompensation following ethanol sclerotherapy under general anesthesia

1 Department of Anesthesiology, Tri-Service General Hospital, National Defense Medical Center, Taipei; Division of Anesthesiology, Zuoying Branch of Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan
2 Department of Anesthesiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan

Correspondence Address:
Yi-Hsuan Huang,
#325, Section 2, Chenggung Road, Neihu 114, Taipei City
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jmedsci.jmedsci_369_21

Ethanol sclerotherapy is a therapeutic method commonly applied to address low-flow vascular malformations. However, numerous complications, including hemodynamic instability, may develop after ethanol injection. We present a case who experienced cardiopulmonary instability during intraoperative percutaneous ethanol injection under general anesthesia and spontaneously recovered 5 min after ethanol injection. The toxic effects of the treatment were associated with the injection volume and may be related to ethanol-induced pulmonary vasoconstriction and transient right ventricular dysfunction. Prompt and proper management, including providing supportive treatment, decreasing pulmonary vascular resistance with pulmonary vasodilators, and improving right ventricular function, should be carefully prepared to minimize the progression of cardiovascular collapse.


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