Permissive hypoxemia permitted postoperative weaning from artificial ventilation after repair of pulmonary atresia

Survival after corrective surgery of pulmonary atresia was associated with low right ventricular pressure, indicating normal pulmonary vascular resist ance. Therefore increased fractional inspiratory oxygen concentration, inha led nitric oxide and intravenous prostacyclin were considered to be effecti ve measures during postoperative intensive care. In a 20-year-old female, conduit repair and unifocalisation of pulmonary at resia with ventricular septal defect and systemic to pulmonary arterial col laterals were performed despite preexisting one-sided pulmonary hypertensio n. During the following postoperative period, normal arterial oxygen satura tion aimed at by means of a high fractional inspiratory oxygen concentratio n, resulted in persistent pulmonary oedema despite fluid restriction. After several trials of weaning from artificial ventilation, permissive hypoxemi a was eventually successful.