Transpulmonary thermodilution and pulse pressure variations in a septic patient with heterotopic cardiac transplantation

Abstract

55-year-old man was admitted to the inten-sive care unit for shock. He had a history ofsevere coronary artery disease and arterialhypertension, and had undergone heterotopic car-diac transplantation 14 years ago for refractive con-gestive heart failure. Persistent ventricular arrhyth-mia attributed to native heart dysfunction wasinitially treated medically. A cardioverter defibril-lator was implanted after recurrence of syncopalventricular tachycardia 2 years ago. On admission,severe hypotension was noted (73/53 mm Hg).Physical examination at the time of admissionshowed no cardiac murmur or abnormal heartsounds. The patient’s heart rate was 90 beats/minand temperature was 38.6°C. Mechanical ventilation(controlled mode, tidal volume 9 mL/kg, respiratoryrate 20 breaths/min, F