Noninvasive ventilation: An important option in the management of hemidiaphragm paralysis.
Christie S CarlsonSarah R BrownMatthew W WilsonPhilip J ChoiPublished in: Journal of cardiac surgery (2021)
Hemidiaphragm paralysis (HP) is a potential complication of cardiac surgery. While most patients are either asymptomatic or have mild symptoms, some are at risk of developing life-threatening hypercapnia. We present a case of a patient who developed HP after tricuspid valve replacement. Diaphragm plication was deferred due to underlying comorbidities, but over time she developed severe hypercapnic respiratory failure requiring intensive care unit admission. Chronic noninvasive ventilation therapy (NIV) was initiated, which improved her symptoms and hypercapnia and prevented further hospitalizations. For patients with iatrogenic HP unable to undergo diaphragm plication, Pulmonology referral for initiation of NIV should be strongly considered.
Keyphrases
- respiratory failure
- mechanical ventilation
- intensive care unit
- acute respiratory distress syndrome
- extracorporeal membrane oxygenation
- cardiac surgery
- end stage renal disease
- aortic valve
- mitral valve
- ejection fraction
- aortic stenosis
- newly diagnosed
- chronic kidney disease
- emergency department
- acute kidney injury
- prognostic factors
- peritoneal dialysis
- sleep quality
- atrial fibrillation
- transcatheter aortic valve replacement
- stem cells
- drug induced
- early onset
- climate change
- coronary artery disease
- bone marrow