BLUNT CARDIAC INJURY AND INTRAOPERATIVE HYPOXEMIA

A 28-yr-old man sustained blunt chest trauma in a motor vehicle accide nt. Severe intraoperative hypoxaemia occurred, unresponsive to oxygen and positive expiratory pressure therapy Trans-oesophageal echocardiog raphy revealed myocardial contusion and tricuspid valve rupture. Dobut amine improved left ventricular function and ejection fraction resulti ng in an immediate improvement in arterial oxygenation and saturation. Tricuspid injury and the diagnosis of myocardial contusion are discus sed. The case highlights the importance of a non-pulmonary mechanism o f hypoxaemia.