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Foreign Body Removal at Right Main Bronchus in A Neonate
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Hyun Su Ri, Sang Wook Shin, Seung Hoon Baek, Hyae Jin Kim, Sun Jae Lee, Seong Wan Baik
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Korean J Crit Care Med. 2013;28(3):201-203.
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DOI: https://doi.org/10.4266/kjccm.2013.28.3.201
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- Foreign body in the airway could be a life-threatening risk, especially for young pediatric patients. A 6-day old male patient with foreign body, which was located deep in the right main bronchus was being admitted. Although we tried three times to remove it with rigid bronchoscopic forceps under the general anesthesia, we failed. Before switching to surgical treatment, we changed the Trendelenburg position and tapped his back several times in order to alter the foreign body toward the forcep. Finally we were able to catch and extract the foreign body successfully. We suggest that back percussion with the Trendelenburg position is a useful solution to remove a foreign body within a deep airway.
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Central Venous Catheter Misplaced in the Innominate Vein after Penetrating the Left Subclavian Vein in a Neonate: A Case Report
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Sang Wook Shin, Ji Uk Yoon, Hyeon Jeong Lee, O Sun Kwon, Hyun Mok Kim
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Korean J Crit Care Med. 2012;27(1):49-51.
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DOI: https://doi.org/10.4266/kjccm.2012.27.1.49
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- In the pediatric ICU and operating room, a central venous catheter (CVC) provides accurate hemodynamic information and serves as a reliable route for the administration of vasoactive drugs, fluids and allogeneic blood products. The placement of CVC is associated with a complication rate of 0.4% to 20%, including hemothorax, pneumothorax, thrombosis, infection and cardiac tamponade. We describe a case of CVC being misplaced in the innominate vein after penetrating the subclavian vein during anesthesia induction for arterial switch operation. Our report discusses the mechanisms by which this mishap took place, and reviews the proper positions of the head, arm, thorax and safe depth of venipuncture for the placement of a CVC in neonates.
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The Use of Thiopental Sodium with BIS Monitoring in Hypoxic Brain Damage
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Jae Young Kwon, Sul Ki Song, Kyung Hoon Kim, Sang Wook Shin, Seong Wan Baik
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Korean J Crit Care Med. 2000;15(1):52-55.
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- Hypoxemia is a common and potentially serious postoperative complication. Hypoxic encephalopahty may occur in prolonged hypoxemia. This condition needs brain protection. There are many brain protective methods. The primary cental nervous system protective mechanism of the barbiturates is attributed to their ability to decrease the cerebral metabolic rate, thus improving the ratio of oxygen (O2) supply to O2 demand. The electroencephalogram-derived bispectral index system (BIS) is a promising new method to predict probability of recovery of consciousness. We experienced two cases of hypoxic brain damage in recovery room. The patients were treated with thiopental and monitored with BIS. The use of thiopental as brain protection during complete global ischemia after cardiac arrest was not effective.
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Profound Hypothermia and Circulatory Arrest for Adult PDA Surgery: Case report
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Seung Hun Baek, Sang Wook Shin, Hae Kyu Kim, Seong Wan Baik, Inn Se Kim, Kyoo Sub Chung
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Korean J Crit Care Med. 1997;12(2):187-191.
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- Correction of a calcified patent ductus arteriosus (PDA) is a difficult surgical procedure. Simple ligation or division of PDA is not possible if diffuse circumferential calcification is present. Several techniques using cardiopulmonary bypass and closure of PDA from within the aorta or pulmonary artery have been introduced. And the surgical procedure is performed under profound hypothermia and circulatory arrest. Total ischemia time should be less than 30 minutes, which is free from the organ damage by the circulatory arrest. Barbiturates, calcium channel blockers and steroids are used for brain protection. We experienced successful use of these techniques for adult female patch closure of PDA and reviewed the anesthetic considerations of the profound hypothermia and circulatory arrest for cardiac surgery.
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Acute Lung Edema from Unknown Cause: A case report
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Changgi Rho, Sang Wook Shin, Hae Kyu Kim, Seong Wan Baik, Inn Se Kim, Kyoo Sub Chung
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Korean J Crit Care Med. 1997;12(1):75-80.
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- Acute lung edema during anesthesia and operation is not common. We experienced a case of 7 year-old boy who developed acute lung edema during open reduction for his fractured lateral condyle of right humerus under general anesthesia with enflurane. In his previous history, we couldn't detect any abnormal finding that could induce lung edema intraoperatively. Preoperative routine laboratory findings and chest x-ray findings were within normal ranges.
In the end of operation, increased airway resistance and sudden facial cyanosis were detected and he received immediate, careful supportive respiratory management. He improved from severe lung edema, but hypoxic brain damage and motor dysfunction resulted. We couldn't find any evidence that he had heart failure, hypoalbuminemia, sepsis, severe trauma, fluid overloading. Authors couldn't get exact causes of acute lung edema in this case.
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