Diffuse alveolar hemorrhage following sugammadex and remifentanil administration: A case report. Issue 8 (February 2019)

• Record Type: Journal Article
• Authors: Choi, Won Kyu; Lee, Jae Myeong; Kim, Jong Bun; Im, Kyong Shil; Park, Bong Hee; Yoo, Su Bin; Park, Cha Yun
• Other Names: NA. section editor.
• Is Part Of: Medicine. Volume 98:Issue 8(2019)
• Publication Date: 2019-02
• Subjects: diffuse alveolar hemorrhage -- negative pressure pulmonary edema -- remifentanil -- sugammadex; Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Geneeskunde; Medicine; Periodicals; Periodicals; 610.5
• DOI: 10.1097/MD.0000000000014626
• Languages: English
• ISSNs: 0025-7974

Abstract

Abstract: Rationale: Diffuse alveolar hemorrhage (DAH) is a rare life-threatening condition that accompanies general anesthesia. Negative-pressure pulmonary edema (NPPE) is a rare cause of DAH. Patient concerns: A 25-year-old male patient developed hemoptysis following remifentanil administration by bolus injection with sugammadex at the emergence from general anesthesia. Diagnosis: Chest x-ray and computed tomography showed DAH. Interventions: Conservative care was provided with 4L of oxygen via nasal prong, 20 mg of Lasix and 2500 mg of tranexamic acid. Outcomes: The patient was discharged uneventfully. Lessons: Muscle rigidity by remifentanil and the dissociated reversal of neuromuscular blockade by sugammadex was suspected as the cause of NPPE-related DAH. Therefore, the possibility NPPE-related DAH should be considered when using a bolus of remifentanil and sugammadex during emergence from general anesthesia.