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KMID : 0352120200350010046
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Journal of Kyung Hee University
2020 Volume.35 No. 1 p.46 ~ p.50
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Cardiogenic Shock During Anesthesia in Anterior/Posterior Lumbar Interbody Fusion: A Case Report
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An Hyeon-Jun
Chung Jun-Young
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Abstract
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When spinal procedures are performed in prone position, pressure is necessarily exerted in the thoracic and abdominal regions. Such pressure induces obstruction of the inferior vena cava which in turn causes venous pooling, resulting in increased blood loss. Hence, many devices have been developed and are currently used to relieve pressure. Among them, a bolster is a device used to cushion the thoracic and abdominal regions, relieving pressure between the two bolsters thus preserving venous return, decreasing venous engorgement and minimizing blood loss. However, the surface area of contact between such devices and the patient is small, causing focal pressure points. Of note, patient malposition can cause severe thoracic wall compression and may even incite cardiogenic shock and must be closely monitored when changing the patient’s position during surgery. In this case, the authors experienced an incidence of cardiogenic shock in a patient receiving anterior posterior lumbar fusion using only abdominal and thoracic bolsters and presents the case along with a review of current literature.
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KEYWORD
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Cardiogenic shock, Prone position, Bolster, Malposition
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