October 2021 Critical Care Case of the Month: Unexpected Post-Operative Shock

• Main Authors: Sharanyah Srinivasan MBBS, Sooraj Kumar MBBS, Benjamin Jarrett MD, Janet Campion MD
• Format: Article
• Language: English
• Published: Arizona Thoracic Society 2021-10-01
• Series: Southwest Journal of Pulmonary and Critical Care
• Subjects: shock; hypotension; obstructive shock; diagnosis; mri; ct scan; treatment; echocardiogram; lipomatous hypertrophy
• Online Access: https://www.swjpcc.com/critical-care/2021/10/1/october-2021-critical-care-case-of-the-month-unexpected-post.html

No abstract available. Article truncated after 150 words. History of Present Illness: A 55-year-old man with a past medical history significant for endocarditis secondary to intravenous drug use, osteomyelitis of the right lower extremity was admitted for ankle debridement. Pre-operative assessment revealed no acute illness complaints and no significant findings on physical examination except for the ongoing right lower extremity wound. He did well during the approximate one-hour “incision and drainage of the right lower extremity wound”, but became severely hypotensive just after the removal of the tourniquet placed on his right lower extremity. Soon thereafter he experienced pulseless electrical activity (PEA) cardiac arrest and was intubated with return of spontaneous circulation being achieved rapidly after the addition of vasopressors. He remained intubated and on pressors when transferred to the intensive care unit for further management. PMH, PSH, SH, and FH: • S/P Right lower extremity incision and drainage for suspected osteomyelitis as above • Distant history of endocarditis related …