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British Journal of Anaesthesia, 2004, Vol. 92, No. 1 149-150
© 2004 The Board of Management and Trustees of the British Journal of Anaesthesia

Correspondence

Acute heart failure during spinal surgery in a boy with Duchenne muscular dystrophy

W. Schummer1, C. Schummer1, J. A. Hayes2, W. A. Ames2, G. N. Schmidt3, M.-A. Burmeister3, F. Wappler3 and P. Bischoff3

1 Jena, Germany 2 Toronto, Canada 3 Hamburg, Germany

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Editor—Schmidt and colleagues1 should be congratulated for their case presentation and the patient’s good outcome. We appreciated the detailed discussion on Duchenne muscular dystrophy (DMD) and perioperative complications. It is striking that preoperative echocardiography may not reflect the intraoperative ability of the diseased myocardium to respond to stress—a situation we are quite often confronted with in clinical scenarios.

The authors raise the question of which intraoperative monitoring should be used for detection of cardiac abnormalities and for adjusting therapy. From our point of view the patient was adequately monitored, at least at the beginning of the operation. Nevertheless, we are surprised that the high arteriovenous PCO2 difference of 15 mm Hg, 30 min after induction of anaesthesia (Fig. 2 of Case Report 1) was . . . [Full Text of this Article]


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