Postprandial Hypotension in the Intensive Care Unit Due To Portal Hypertension and Coronavirus Disease 2019: A Case Report

A 49-year-old man with cirrhosis and portal hypertension was admitted for acute respiratory distress syndrome secondary to coronavirus disease 2019 (COVID-19) pneumonia. His course was complicated by postprandial hypotension (PPH)-episodic hemodynamic collapse that occurred minutes after enteral administration of medications or fluids. Octreotide, which reduces splanchnic pooling and can treat PPH, successfully prevented ongoing events. PPH is associated with mortality in the outpatient setting, and at-risk patients include the elderly and those with autonomic dysfunction, including those with COVID-19. Portal hypertension is a likely additional risk factor that has not been previously described. Octreotide is the mainstay of PPH prophylaxis.