Key result
In an 87-year-old female with severe pulmonary hypertension and right ventricular dysfunction, tailored anesthesia management improved perioperative outcomes during hip fracture repair.
Why the study?
Perioperative right ventricular dysfunction is life-threatening, and anesthetic management of elderly patients with hip fractures and advanced cardiac disease carries considerable perioperative risks.
Highlights individualized anesthetic planning and the use of pulmonary vasodilators for managing acute RV decompensation in high-risk geriatric patients undergoing urgent surgery.
Perioperative right ventricular dysfunction can be life-threatening. Anesthetic management of elderly patients with hip fractures and advanced cardiac disease poses considerable perioperative risks. The problem-based learning discussion examines the management of an 87-year-old female with severe pulmonary hypertension, right ventricular dysfunction, and recent anticoagulation scheduled for urgent hip fracture repair. A tailored management approach included peripheral nerve blocks, intraoperative transesophageal echocardiographic monitoring, goal-directed hemodynamic support, and management of acute RV decompensation with intratracheal milrinone and inhaled epoprostenol. It presents strategies for high-risk geriatric trauma patients, individualized anesthetic planning, and the role of pulmonary vasodilators.
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Arthur et al. (2026) studied this question. In an 87-year-old female with severe pulmonary hypertension and right ventricular dysfunction, tailored anesthesia management improved perioperative outcomes during hip fracture repair.
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