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Acute pulmonary oedema and hyperchloraemic metabolic acidosis following operative hysteroscopy using sodium chloride 0.9%
Author(s) -
Summers G. C.,
Fosker S. R.,
Faris R.,
Handy J. M.
Publication year - 2020
Publication title -
anaesthesia reports
Language(s) - English
Resource type - Journals
ISSN - 2637-3726
DOI - 10.1002/anr3.12080
Subject(s) - metabolic acidosis , medicine , hysteroscopy , distension , anesthesia , complication , abdominal distension , acidosis , surgery
Summary Fluid media including sodium chloride 0.9% are used during operative hysteroscopy to provide uterine distension and aid visualisation. Volume overload is a known complication of their use but is usually associated with long procedures or uterine tissue dissection. A previously well 40‐year‐old woman presented for hysteroscopy and evacuation of retained products of conception under general anaesthesia. On emergence, she developed respiratory compromise and a hyperchloraemic metabolic acidosis in keeping with acute pulmonary oedema induced by sodium chloride 0.9% fluid overload. Anaesthetists must remain vigilant during operative procedures using distension media. Additionally, they should be familiar with the clinical and metabolic manifestations consistent with systemic transfusion of such media.