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Usability of Esophageal Doppler for Monitoring of Concealed Retroperitoneal Hemorrhage during Laparoscopy Assisted Subtotal Gastrectomy
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Sung Ha Mun, Seung Hwan Lee, Min Young No
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Korean J Crit Care Med. 2012;27(2):134-138.
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DOI: https://doi.org/10.4266/kjccm.2012.27.2.134
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- Hemodynamic monitoring is an essential element in the management of perioperative patients. In addition, anesthesiologists routinely used blood pressure (invasive or non invasive), heart rate, urinary output and central venous pressure as monitoring modalities. Esophageal doppler monitoring, as a minimally invasive hemodynamic assessment tool, has a good correlation with pulmonary artery catheterization in measuring cardiac output. We experienced a case of concealed retroperitoneal hemorrhage in a patient who underwent a laparoscopic subtotal gastrectomy. When surgeons tried to close trocar sites, the patient's blood pressure dropped rapidly. At laparoscopy, we could not find gross bleeding. However, we could detect hypovolemia by esophageal doppler monitoring (CardioQ, Deltex(TM), UK). The procedure was converted to open laparotomy. Thereafter, we could find retroperitoneal hemorrhage, and vascular repair was done successfully. The patient recovered without any other complications.
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Neurogenic-stunned Myocardium and Pulmonary Edema Following a Ruptured Cerebral Aneurysm: A Case Report
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Sung Ha Mun, Won Joon Choi, Jeong Min Mok, Jae Young Yang, Chul Ho Woo
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Korean J Crit Care Med. 2010;25(2):93-97.
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DOI: https://doi.org/10.4266/kjccm.2010.25.2.93
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Abstract
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- We report a case of neurogenic cardiopulmonary instability with pulmonary edema occurring after an aneurysmal subarachnoid hemorrhage. The patient's pre-operative Glasgow coma scale score was 6 and the PA chest radiograph showed increased diffuse haziness in the right lung field. The patient presented with severe hypotension and low oxygen saturation during surgery. Cardiac damage was documented by increased CK-MB troponin-T levels, and ischemic ECG findings. Reversible cardiac failure associated with subarachnoid hemorrhage may be due to a neurogenic-stunned myocardium. The patient underwent clipping of the aneurysm and recovered with minimal neurologic impairment and normal cardiac function.
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Citations
Citations to this article as recorded by  - A Retrospective Study about Characteristics of Out-of-hospital Cardiac Arrest Caused by Non-traumatic Subarachnoid Hemorrhage
Min Seob Sim, Ki Dong Sung, Mun Ju Kang, Ji Ung Na, Tae Gun Shin, Ik Joon Jo, Hyoung Gon Song, Keun Jeong Song, Yeon Kwon Jeong
The Korean Journal of Critical Care Medicine.2011; 26(3): 151. CrossRef
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Use of Laryngeal Mask Airway Proseal for Stereotactic Biopsy of Brain Tumor in which Difficult Intubation was Expected under General Anesthesia: A Case Report
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Yun Hong Kim, Hyun Soo Kim, Sung Ha Mun, Hyun Seung Lee
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Korean J Crit Care Med. 2004;19(1):47-51.
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- Stereotactic surgery is a technique allowing the operation of an intracranial lesion without the need for craniotomy.
Now stereotactic technique is widely used for aspiration of brain abscess or hemorrhage, biopsy of brain tumor and treatment of movement disorder etc. Because of the frame of stereotactic system, that is fixed on the scalp, laryngoscopic endotracheal intubation may be disturbed. So, in this case, we used laryngeal mask airway Proseal (PLMA(TM)) for maintenance of airway during stereotactic biopsy of brain tumor under general anesthesia. It was easily to insert PLMA(TM) using the introducer at once. The ventilation during the operation was not impeded at all time. There were not excessively changes of vital sign during general anesthesia. We think that PLMA(TM) may be a good alternative method for maintenance of airway during stereotactic surgery under general anesthesia.
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