| Title | When drugs disappear from the patient: elimination of intravenous medication by hemodiafiltration. | | Author(s) | Stricker KH, Takala J, Hullin R, Ganter CC | | Institution | Departments of Intensive Care Medicine, Bern University Hospital and University of Bern, Inselspital, Bern, Switzerland. | | Source | Anesth Analg 2009 Nov; 109(5):1640-3. | | MeSH | Acute Disease
Adrenergic alpha-Agonists
Adult
Catheterization, Central Venous
Epinephrine
Female
Heart Failure
Heart Transplantation
Hemodynamics
Hemofiltration
Humans
Hypertension
Hypnotics and Sedatives
Infusions, Intravenous
Injections, Intravenous
Neuromuscular Agents
| | Abstract | Twenty-three hours after heart transplantation, life-threatening acute right heart failure was diagnosed in a patient requiring continuous venovenous hemodiafiltration (CVVHDF). Increasing doses of catecholamines, sedatives, and muscle relaxants administered through a central venous catheter were ineffective. However, a bolus of epinephrine injected through an alternative catheter provoked a hypertensive crisis. Thus, interference with the central venous infusion by the dialysis catheter was suspected. The catheters were changed, and hemodynamics stabilized at lower catecholamine doses. When the effects of IV drugs are inadequate in patients receiving CVVHDF, interference with adjacent catheters resulting in elimination of the drug by CVVHDF should be suspected. | | Language | eng | | Pub Type(s) | Case Reports
Journal Article
| | PubMed ID | 19843802 |
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