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Intensive Care Medicine

, Volume 37, Issue 7, pp 1223–1224 | Cite as

Myocardial ischaemia and weaning failure: is angioplasty the heart of the problem?

  • C. Carrié
  • H. N. Bui
  • E. Gerbaud
  • F. Vargas
  • G. Hilbert
Correspondence

Dear Editor,

We report the case of a 79-year-old patient admitted to our medical intensive care unit with acute respiratory distress because of an amiodarone-induced interstitial pneumonia, for which refractory hypoxaemia required intubation. Chronic ischaemic heart disease, with 40% of left ventricular ejection fraction (LVEF), was controlled by medical treatment. Although coronary angiography 1 year previously had shown severe stenosis of the left anterior artery, no revascularization had been performed to date.

A first weaning process was attempted after 10 days of mechanical ventilation after gradual improvement in respiratory function with corticosteroids and antibiotics. Levels of brain natriuretic peptide (BNP) and troponin, and the values of LVEF and filling pressures are presented in Table  1. Electrocardiography showed diffuse disorders of repolarization, but no deviation from baseline (Fig.  1, ECG 0). There was no proof of infection and no signs of neuromyopathy. On day 14,...

Keywords

Left Ventricular Ejection Fraction Dobutamine Brain Natriuretic Peptide Brain Natriuretic Peptide Level Spontaneous Breathing Trial 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Copyright jointly held by Springer and ESICM 2011

Authors and Affiliations

  • C. Carrié
    • 1
  • H. N. Bui
    • 1
  • E. Gerbaud
    • 2
  • F. Vargas
    • 1
  • G. Hilbert
    • 1
  1. 1.Departement de réanimation MédicaleHopital Pellegrin-TripodeBordeauxFrance
  2. 2.Services des Soins Intensifs-Cardiologie InterventionnelleHôpital Haut LévêquePessac cedexFrance

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