Thank God, the patient survived and extubated well, and managed to continue her further monitoring and treatment in general ward outside ICU.
What we did was unique and physiologically plausible. We do not have Ivabradine, thus we started trial of IV Labetalol boluses which shown improved blood pressure when the heart slowed down, so confirmed it's tachycardia induced hypotension. Following that, we started Labetalol infusion on top of vasopressor inotropic agents. Slowly, we managed to get the heart rate down to 160bpm and decided to overlap with oral Bisoprolol. Labetalol and vasopressor infusion were managed to wean off 12 hours later and slowly we got her off from ventilator 48 hours later.
Felt relieved when the young mother was able to get out from the 200bpm pathology heart. What a case, given me an extraordinary experience. My supervisor had not encounter any case like this, it was her first encounter with the 200bpm heart that continued for 48 hours before we managed to get the heart rate controlled.
Thank God again, indeed prayer works......
No comments:
Post a Comment