Severe Hypoxemia during Mechanical Ventilation after an Elective Bentall Procedure: A Case Report

Acute Hypoxemic Respiratory Failure (AHRF) during mechanical ventilation on high fraction of inspired oxygen is an unusual manifestation of respiratory insufficiency after an elective cardiac surgical procedure. A 68-year old man who had developed AHRF during his mechanical ventilatory support after an elective Bentall procedure was reported. Increased duration of cardiopulmonary bypass in conjunction with his hemodynamic instability and tissue hypo-perfusion during the early postoperative period were the main reasons for the acute respiratory failure onset accompanied by severe hypoxemia. A slow oxygenation improvement was observed after the implementation of specific interventions for arterial pressure and heart rhythm stabilization. Considering the patient’s clear chest x-ray findings, it was supposed that he had progressed to type IV respiratory failure. Hemodynamic stabilization and improvement of tissue perfusion could treat the underlying cause of the patient’s acute respiratory failure.