Intensive Care Medicine

, Volume 37, Issue 4, pp 723–724 | Cite as

Acute right heart decompensation in a multiple trauma patient with chronic pulmonary hypertension

  • Steffen Weber-CarstensEmail author
  • Christian Lojewski
  • Sven Bercker
  • Klaus-Dieter Schaser
  • Suzanne Fateh-Moghadam
  • Udo Kaisers

Dear Editor,

We report a case of a 35-year-old woman with a history of long-standing idiopathic pulmonary arterial hypertension [PAH, resting mean pulmonary arterial pressure (mPAP) of 75 mmHg], who was involved in a serious motor vehicle accident. Over the previous 12 years, the patient sustained a high quality of life, as she was successfully treated with orally administered endothelin-receptor antagonist bosentan, continuous intravenous prostacyclin (epoprostenol) infusion through an ambulatory pump device, warfarin and diuretic agents [1, 2].

Clinical examination and diagnostic imaging after the accident revealed severe multiple trauma—involving thorax, pelvis, retroperitoneal bleeding and right kidney rupture (injury severity score of 41). Despite uninterrupted epoprostenol infusion, the newly placed pulmonary artery catheter revealed a mean PAP of 115 mmHg—far above the patient’s baseline. It was then decided to limit immediate surgical management to life- and limb-saving...


Pulmonary Arterial Hypertension Bosentan Spontaneous Breathing Epoprostenol Hypoxic Pulmonary Vasoconstriction 
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Copyright information

© Copyright jointly held by Springer and ESICM 2011

Authors and Affiliations

  • Steffen Weber-Carstens
    • 1
    Email author
  • Christian Lojewski
    • 1
  • Sven Bercker
    • 2
  • Klaus-Dieter Schaser
    • 3
  • Suzanne Fateh-Moghadam
    • 4
  • Udo Kaisers
    • 2
  1. 1.Department of Anesthesiology and Intensive Care Medicine, Campus Virchow-Klinikum and Campus Charité MitteCharité-Universitätsmedizin BerlinBerlinGermany
  2. 2.Deptartment of Anesthesiology and Intensive Care Medicine, Medical FacultyUniversity of LeipzigLeipzigGermany
  3. 3.Center for Musculoskeletal Surgery, Campus Virchow-KlinikumCharité-Universitätsmedizin BerlinBerlinGermany
  4. 4.Department of Cardiology and Cardiovascular MedicineUniversity Clinic of TuebingenTuebingenGermany

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