Effectiveness of milrinone for cardiogenic shock due to massive pulmonary aspiration: a case report

Area of Science:

• Anesthesiology
• Critical Care Medicine
• Cardiology

Background:

• Pulmonary aspiration of gastric contents is a serious anesthesia complication.
• While rare, severe hypoxemia and other sequelae can occur.
• Massive aspiration can lead to life-threatening cardiac events.

Purpose of the Study:

• To report a rare case of massive gastric aspiration during anesthesia induction.
• To describe the resulting severe pulmonary hypertension and myocardial infarction.
• To highlight the successful treatment of refractory cardiac arrest with milrinone.

Main Methods:

• Case report of a patient undergoing general anesthesia.
• Documented massive pulmonary aspiration during induction.
• Managed cardiac arrest and shock unresponsive to conventional therapy.
• Administered milrinone for sustained resuscitation.

Main Results:

• Massive aspiration led to cardiac arrest from pulmonary hypertension and myocardial infarction.
• Conventional resuscitation was initially ineffective.
• Milrinone administration successfully restored circulation and cardiac function.
• The patient recovered without complications within 20 days.

Conclusions:

• Massive pulmonary aspiration is a critical event requiring prompt and potentially unconventional management.
• Milrinone can be an effective treatment for refractory cardiac arrest and shock caused by severe pulmonary hypertension post-aspiration.
• Early and aggressive intervention can lead to favorable outcomes even in severe cases.