The Anesthetic Challenges of Lung Biopsy–Associated Intrathoracic Hemorrhage in a Child With Suprasystemic Pulmonary Hypertension

Abstract

Children with suspected pulmonary hypertension must undergo extensive and invasive evaluations to establish a definitive diagnosis. A previously healthy 4-year old girl, newly diagnosed with suprasystemic pulmonary hypertension required multiple lung biopsies. Each procedure was associated with significant bleeding. The challenging anesthetic management of lung biopsy in the presence of suprasystemic pulmonary hypertension is described.

Sir William Harvey, Congenital Heart Disease and Anesthesia

“…In this issue, Clopton and colleagues remind us of the dangers of managing patients with suprasystemic pulmonary hypertension, especially when they are first diagnosed. 7 In their article, they describe a 4-year-old girl with a new diagnosis of suprasystemic pulmonary hypertension of unclear etiology who undergoes a lung biopsy and has acute hemorrhage from the biopsy site. Not only does she have significant bleeding during the biopsy but several hours later in the intensive care unit she bleeds again.…”