-
Massive Diffuse Alveolar Hemorrhage Caused by the Aspiration of Gastric Contents during Induction of Anesthesia in Patients with Adhesive Ileus: A Case Report
-
Ji Seon Jeong, Jong Hun Jun, Hyo Jin Song, Hee Koo Yoo
-
Korean J Crit Care Med. 2012;27(2):115-119.
-
DOI: https://doi.org/10.4266/kjccm.2012.27.2.115
-
-
 Abstract
 PDF
- Aspiration pneumonitis is best defined as an acute lung injury, following the aspiration of regurgitated gastric contents. Major cause of pulmonary aspiration, during anesthesia, is gastric contents. Pulmonary aspiration can present symptoms of wheezing, coughing, dyspnea, cyanosis, pulmonary edema, hypotension, and hypoxemia, which may progress rapidly to severe acute respiratory distress syndrome (ARDS). However, there was no report of massive alveolar hemorrhage associated with aspiration pneumonitis.
A 63-year-old man, who had undergone a total gastrectomy and received adjuvant chemotherapy, four months ago, was scheduled for adhesiolysis of the small bowel. The patient occurred aspiration of gastric contents, during induction of anesthesia, and subsequently, hypoxia developed during surgery. The patient moved to an intensive care unit (ICU), without extubation. Mechanical ventilation with PEEP was performed in an ICU. However, the patient died by ARDS and massive alveolar hemorrhage.
-
Pulmonary Embolism Detected in the General Ward after Operation: A Case Report
-
Se Hyun Lew, Jong Hun Jun, Hee Koo Yoo, Yong Ho Kim
-
Korean J Crit Care Med. 2004;19(1):38-41.
-
-
-
Abstract
PDF
- Pulmonary embolism is a common medical complication following major orthopedic procedures of the lower extremities and a leading cause of morbidity and mortality.
However, the clinical manifestations of pulmonary embolism are nonspecific and it may be difficult to diagnose. An 82 years old female with severe restrictive pulmonary disease received the elective operation for the fracture of left femur neck under combined spinal-epidural anesthesia. During the operation, we sometimes gave her oxygen via face mask and maintained oxygen saturation of more than 80% which was measured by a pulse oxymeter. The operation and anesthesia was performed uneventfully. On the seventh postoperative day, she showed tachycardia suddenly and cardiac arrest later on the electrocardiogram. After cardiopulmonary resuscitation, she was transferred to intensive care unit and checked by a computed tomography and echocardiography.
She was diagnosed with pulmonary embolism and deep vein thrombosis and treated with heparin and urokinase. But she did not improve and died.
-
Severe Hyperkalemia without Typical Electrocardiographic Manifestations: A case report
-
Sang Beom Nam, Hee Koo Yoo
-
Korean J Crit Care Med. 1999;14(1):42-46.
-
-
-
Abstract
PDF
- Severe hyperkalemia can induce life threatening cardiac rhythm disturbances, and usually produce classic electrocardiographic (EKG) manifestations. We report a case of severe hyperkalemia in which the EKG did not reveal the expected alterations. The patient was a 57-year-old man with adenocarcinoma of stomach. There were no significant abnormal findings in laboratory analysis, chest X-ray and EKG. His preoperative medications for hypertension consisted of furosemide, amiloride and enalapril. The tests for serum potassium concentration ([K ]) were performed on 20 and 7 days before the operation and the results were 4.5 and 4.9 mEq/l, respectively. Just after induction of anesthesia, we tried the blood gas and electrolyte analysis and the result revealed high [K ] of 8.5 mEq/l, but EKG did not show typical phenotype of hyperkalemia at that time. His intraoperative and postoperative courses were not eventful.
|
KSCCM
