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Hemodynamic Instability due to Adrenal Insufficiency after Open Heart Surgery

개심술 후 부신피질 결핍증에 의한 혈역학적 불안정

  • Kim, Hye-Won (Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Chung, Cheol-Hyun (Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine)
  • 김혜원 (울산대학교 의과대학 서울아산병원 흉부외과학교실) ;
  • 정철현 (울산대학교 의과대학 서울아산병원 흉부외과학교실)
  • Received : 2009.09.16
  • Accepted : 2009.10.20
  • Published : 2010.04.05

Abstract

Unexplained hypotension during a stay in the ICU is not uncommon in patients who underwent major surgery such as open heart surgery. When the cardiac output of patients is low, the heart may be the origin of this problem. If the heart function is normal, then we have to consider adrenal insufficiency as a possible cause of this hypotension. Adrenal insufficiency is a rare condition in the general population, yet patients who are under a stressful condition might experience adrenal insufficiency more frequently. We report here on a case of a patient who was in an unstable postoperative state with adrenal insufficiency after surgery and the patient dramatically recovered after the replacement of hydrocortisone.

개심술과 같은 큰 수술을 받은 환자가 중환자실 치료 중 저혈압을 겪게 되는 경우는 드물지 않다. 환자의 심장 기능이상이 주요 원인이지만 부신피질 결핍에 의한 경우도 한 원인이 될 수 있다. 부신피질 호르몬 결핍증은 일반인에게는 매우 드물지만, 수술과 같은 스트레스 상황에 처한 환자들에게서는 종종 볼 수 있다. 본 증례는 개심술 후 발생한 부신피질 호르몬 결핍증을 치료한 경우로, 극심한 저혈압으로부터 hydrocortisone 투여 후 극적인 회복을 보여주는 예이다.

Keywords

References

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