Hypoxemia with stress cardiomyopathy following liver transplant: Is there a role for nitric oxide? - A case report

Hypoxemia with stress cardiomyopathy following liver transplant: Is there a role for nitric oxide? - A case report

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Patients with liver disease can have varied cardiac manifestations including pulmonary arteriovenous dilatation.The stress edgewater shoes of surgery associated with catecholamine surges can also potentiate stress-related changes.We report management of hypoxemia in a patient who underwent liver transplantation.Although her preoperative oxygenation (SpO2 97%) measured 2 weeks earlier was normal, she manifested hypoxemia on the day of surgery and cardiovascular failure perioperatively.

Postoperative investigations revealed a stress cardiomyopathy.The cause of persistent and refractory hypoxemia was uncertain in the context of normal preoperative tests.However, she responded immediately to inhaled nitric oxide, suggesting a correction of ventilation perfusion dynamics.We wish to highlight a possible role of nitric oxide in postoperative 5326058hx liver transplant patients with refractory hypoxemia of uncertain etiology.