ABSTRACT
There were so many causes of chronic coughing including postnasal drip, pneumonia, nasal polyp, asthma, interstinal lung disease etc. Congenital bronchoesophageal fistula was not usually thought as cause of chronic coughing. A 46-year-old female patient suffered from chronic coughing without usual causes. Her chest X-ray viewed normally. She coughed especially after swallowing foods. So we recommended her esophagogram and it revealed broncho-esphageal fistula. She underwent surgical resection of broncho-esophageal fistula. She was well without cough after the surgery. We reported a case of congenital broncho-esphageal fistula that had caused chronic coughing without any evidence of pneumonia, malignancy, tuberculosis, bronchiectasis, inflammation, asthma, nasal polyp, etc. So we should suspect the bronchoesophageal fistula when patients cough chronically with eating, and recommend the esophagogram.
Subject(s)
Female , Humans , Middle Aged , Asthma , Bronchiectasis , Cough , Deglutition , Eating , Fistula , Inflammation , Lung Diseases , Nasal Polyps , Pneumonia , Thorax , TuberculosisABSTRACT
When difficulties occur during anesthesia and the management of intensive care patients, there may not be sufficient time for frequent, accurate and detailed recordings which are essential for medico-legal purposes and the retrieval of information. However, it is during such occasions that the collection of an accurate, detailed record may be nearly impossible. A system, bases on the 16bits microcomputer linked to a Datascope 2000, has been developed to collect cardiovascular data on line from a cardiovascular monitor. The computer can be operated by using the main anesthetic record program written in a C language which enables the interrupt facility in the microcomputer and interface card to detect and store data transmitted from the Datascope. Patient's details are entered by manipulating function keys on the keybord. All information is stored on a disc for subsequent analysis. A formed graph and text can be displayed on the screen. The graph and all the information entered can be printed out at the end of the operation to form a complete anesthetic record.
Subject(s)
Humans , Anesthesia , Critical Care , MicrocomputersABSTRACT
Differential independent lung ventilation is gaining growing attention for management of patients with unilateral pulmonary pathology. This case presents the method for the intraoperative anesthetic management of a patient with empyema and bronchopleural fistula of the left lung which could be controlled by the use of dual-mode asynchronous lung ventilation. The healthy right lung was ventilated by a conventional mechanical ventilator and disessde left lung by a high frequency jet ventilator. The use of endotracheal anesthesia and high frequency ventilation were necessary to prevent drainage of infected secretions into the right side healthy lung and to achieve good gas exchange in the presence of a bronchoplsural fistula. The method used by us, high frequency ventilation for the diseased lung a conventional mechanical ventilation for the other, demonstrated that differential independent lung ventilation using double lumen tube as in this case was suited for handling the problem of a bronchopleural fistula and empyema, further extending the indication for a giant lung bulls, lung cyst, major tracheobronchial disruption and one lung contaminating the other lung with either infected material or blood.
Subject(s)
Humans , Anesthesia , Drainage , Empyema , Fistula , High-Frequency Ventilation , Lung , Pathology , Respiration, Artificial , Ventilation , Ventilators, MechanicalABSTRACT
Open heart surgery under cardiopulmonary bypass which is combined with moderate hypothermia and 5% dextrose priming offers several advantages over the conventional methods; i.e., simplification of the machine, economy in operation, elimination of the need for a large amount of heparinized blood, avoidance of hemaological complications and utilization of the unit as a standby method. The results of open heart operations with this method in our initial 10 cases were comparable to other methods. None of the complications and the mortality were directly attributable to the oxygenator itself.
ABSTRACT
A hypothermic, low flow perfusion, using 5% dextrose in water as the priming fluid in the pump-oxygenator, was carried out to observe oxygen consumption, blood pH changes, and CO2 tension during the bypass period. A low oxygen consumption which was approximately one third of the preperfusion value, was observed during the total by-pass period. This is believed to be due to the effect of low flow rates employed, hypothermia and low CO2 tension observed in these animals. The pH of the arterial blood and the partition of the total CO2 remained within a fairly normal range. There was a marked reduction in CO2 tension during the bypass period. Its harmful effect on the oxyhemoglobin dissociation curve and cerebral circulation was discussed. The hemodilution attendant to the use of 5% dextrose in water as the priming fluid is considered insignificant.