Loss of Haemodynamic Coherence, Diagnosed Using a Continuous Monitoring of Oesophageal Photoplethysmography

Özet

We report the case of a 75-year-old man with appendicular peritonitis in whom we observed oesophageal tissue perfusion, using a new photoplethysmographic probe. As the patient suffered from lactic acidosis, we chose to increase the mean arterial pressure (MAP) using norepinephrine.Thanks to an oesophageal photoplethysmographic signal, we could observe a loss of haemodynamic coherence and a severe alteration of tissueperfusion triggered by the MAP increase. Considering new information regarding the tissue perfusion status, we were able to adjust our MAPtargets accordingly and restore the initial perfusion index values. This case illustrates the loss of haemodynamic coherence and highlights theclinical relevance of continuous tissue perfusion monitoring to highlight potential adverse norepinephrine effects.