Hai giờ postoperatively có một giảm đáng kể huyết áp 80/47. Ông được truyền dịch qua đường tĩnh mạch tăng lên. Đối với 3,5 h tiếp theo, huyết áp thay đổi từ một cao 105/68 thấp của 66/40. Điều này được theo dõi trong 1 giờ và 10 phút huyết áp tâm thu trong những năm 70. | 398 59 Medical Legal Problems in Liposuction posuction. Two hours postoperatively there was a significant drop in blood pressure to 80 47. He was given increased intravenous fluids. For the next h the blood pressure varied from a high of 105 68 to a low of 66 40. This was followed for the next 1 h and 10 min by systolic blood pressures in the 70s. The patient was then transferred to the intensive care unit. HCT ordered at 1945 hours was reported at 2100 hours as . Repeat HCT at 2245 hours was . Packed cells were ordered at 0005 hours on July 3 1998 and transfusions were begun at 0015 hours. The patient had cardiac arrest at 0030 hours and was pronounced dead at 0135 hours. Autopsy showed the cause of death to be from exsanguination with 1 600 ml of blood in the liposuction area of the abdominal wall 400 ml in the scrotal sac and extensive hemorrhage in the subcutaneous tissues extending to the back. There was a settlement for an undisclosed amount. Comment Hypotension following a major surgical procedure is primarily caused by blood loss. HCT should have been ordered 2 h postoperatively when the first hypotensive episode occurred. The low blood pressure did not respond adequately to crystalloids. When the HCT was at 2100 hours blood should have been given. Packed cells are not indicated for hypotension following blood loss unless albumin or Hespan is used at the same time. Whole blood is the better means of expanding the vascular volume. By the time the patient had had severe hypotension for over 1 h there was little likelihood of survival because of irreversible shock from extensive tissue damage. A timely diagnosis and treatment of blood loss would have saved this patient s life. Estate of Marinelli vs Geffner New Jersey Superior Court 1999 . In Medical Malpractice Verdicts Settlements Experts 1999 15 8 37 The 23-year-old female plaintiff s decedent had liposuction by the defendant dermatologist in May 1994. One day following the surgery .
