1. Diffuse alveolar hemorrhage following sugammadex and remifentanil administration
- Author
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Choi, Won Kyu, Lee, Jae Myeong, Kim, Jong Bun, Im, Kyong Shil, Park, Bong Hee, Yoo, Su Bin, and Park, Cha Yun
- Subjects
Adult ,Lung Diseases ,Male ,Hemoptysis ,diffuse alveolar hemorrhage ,Hemorrhage ,Pulmonary Edema ,Anesthesia, General ,Sugammadex ,Analgesics, Opioid ,Remifentanil ,negative pressure pulmonary edema ,Humans ,Clinical Case Report ,Tomography, X-Ray Computed ,Lung ,Research Article - Abstract
Rationale: Diffuse alveolar hemorrhage (DAH) is a rare life-threatening condition that accompanies general anesthesia. Negative-pressure pulmonary edema (NPPE) is a rare cause of DAH. Patient concerns: A 25-year-old male patient developed hemoptysis following remifentanil administration by bolus injection with sugammadex at the emergence from general anesthesia. Diagnosis: Chest x-ray and computed tomography showed DAH. Interventions: Conservative care was provided with 4L of oxygen via nasal prong, 20 mg of Lasix and 2500 mg of tranexamic acid. Outcomes: The patient was discharged uneventfully. Lessons: Muscle rigidity by remifentanil and the dissociated reversal of neuromuscular blockade by sugammadex was suspected as the cause of NPPE-related DAH. Therefore, the possibility NPPE-related DAH should be considered when using a bolus of remifentanil and sugammadex during emergence from general anesthesia.
- Published
- 2019