Abstract
A case of severe hypoxemia during anesthesia of subarachnoid hemorrhage is reported. The patient was a 22-year-old female, who was scheduled for an emergency operation. Severe hypoxemia due to pulmonary edema developed during the induction of anesthesia. Although she received various treatments for hypoxemia, her condition did not improve. The operation was discontinued and she was placed in ICU. Chest X-ray showed a typical pattern of snowstorm-like shadowing. We ventilated her with PEEP, and adminis-tered manitol, sodium pentobarbital and steroid. Following this therapy, her respiratory and circulatory condition improved remarkably after one day. The operation was completed one week later, and her postoperative course was uneventful. Neurogenic pulmonary edema was considered to be the most probable course of her acute respiratory failure. It is associated with a massive sympathetic response, and usually develops after subarachnoid hemorrhage, head trauma, etc. In this case, the respiratory dysfunction was considered to be a result of the stimulus of the induction of anesthesia.
