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Intraoperative cardiac arrest: was it the ACE inhibitor?

Authors
Publisher
Elsevier Inc.
Volume
26
Issue
1
Identifiers
DOI: 10.1016/j.jclinane.2013.10.002
Keywords
  • Ace Inhibitor
  • Angiotensin-Converting Enzyme (Ace)
  • Cardiac Arrest Intraoperative
  • Renin-Angiotensin-Aldosterone System Antagonist
Disciplines
  • Biology
  • Medicine
  • Pharmacology

Abstract

Abstract Continuing renin-angiotensin-aldosterone system antagonist therapy on the day of surgery is controversial, and appears to contribute to intraoperative hypotension. A patient presenting for cerebral aneurysm clipping continued her angiotensin-converting enzyme inhibitor on the morning of surgery, and subsequently experienced significant postinduction hypotension that culminated in cardiac arrest. Following successful resuscitation, she returned 6 weeks later to have her aneurysm clipped using identical anesthetic management; her blood pressure medications were held on the day of surgery.

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