ABSTRACT
Background@#This study assessed the effect of a single bolus administration of lidocaine on the prevention of tourniquet-induced hypertension (TIH) and compared the effect of lidocaine to that of ketamine in patients undergoing general anesthesia. @*Methods@#This randomized, controlled, double-blind study included 75 patients who underwent lower limb surgery using a tourniquet. The patients were administered lidocaine (1.5 mg/kg, n = 25), ketamine (0.2 mg/kg, n = 25) or placebo (n = 25). The study drugs were administered intravenously 10 min before tourniquet inflation. Systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) were measured before tourniquet inflation, after tourniquet inflation for 60 min at 10 min intervals, and immediately after tourniquet deflation. The incidence of TIH, defined as an increase of 30% or more in SBP or DBP during tourniquet inflation, was also recorded. @*Results@#SBP, DBP, and HR increased significantly over time in the control group compared to those in the lidocaine and ketamine groups for 60 min after tourniquet inflation (P < 0.001, P < 0.001, and P = 0.007, respectively). The incidence of TIH was significantly lower in the lidocaine (n = 4, 16%) and ketamine (n = 3, 12%) group than in the control group (n = 14, 56%) (P = 0.001). @*Conclusion@#Single-bolus lidocaine effectively attenuated blood pressure increase due to tourniquet inflation, with an effect comparable to that of bolus ketamine.
ABSTRACT
Arrhythmias occurring during surgery are mostly benign and improve without special treatment, but sometimes life threatening and poor vital signs may require immediate antiarrhythmic or electrotherapy. In some cases, permanent arrhythmias may require continued treatment after surgery. A cardiac event occurred to a 28-year-old man who underwent Bile duct resection/Roux-en-Y hepaticojejunostomy due to cholelithiasis with cholecystitis and choledocholithiasis. He diagnosed mental retardation level 2. Pre-operation laboratory test is normal except liver function test (AST 64, ALT 141). Electrocardiography shows 57 bpm heart rate, sinus rhythm, first degree AV block and long corrected QT interval that was checked 462ms and echocardiography shows LVEF 67%, normal echocardiogram. When we prepared extubation after finishing operation, Sugammadex 200mg was injected. Suddenly, patient’s oxygen saturation was low at 85%. We started manual ventilation for oxygenation and saturation was increased at 100%. When we extubated endotracheal tube, his ECG changed NSR to idiopathic VT. Firstly we considered that is PSVT and infused adenosine 6mg twice and 12mg once. But arrhythmia was continuous and vital sign changed unstable. We performed reintubation and defibrillated at 200J. After defibrillation, arrhythmia converted sinus rhythm. We transferred the patient to the ICU and evaluated further to see if the patient had heart problems. During admission in ICU, attending surgeon tried to extubate endotracheal tube 2 more times. But, Idiopathic VT occurred whenever try to extubate. Finally, in the fourth attempt, extubation without occurrence of VT succeeded with continuous IV esmolol and dexmedetomidine.
ABSTRACT
Arrhythmias occurring during surgery are mostly benign and improve without special treatment, but sometimes life threatening and poor vital signs may require immediate antiarrhythmic or electrotherapy. In some cases, permanent arrhythmias may require continued treatment after surgery. A cardiac event occurred to a 28-year-old man who underwent Bile duct resection/Roux-en-Y hepaticojejunostomy due to cholelithiasis with cholecystitis and choledocholithiasis. He diagnosed mental retardation level 2. Pre-operation laboratory test is normal except liver function test (AST 64, ALT 141). Electrocardiography shows 57 bpm heart rate, sinus rhythm, first degree AV block and long corrected QT interval that was checked 462ms and echocardiography shows LVEF 67%, normal echocardiogram. When we prepared extubation after finishing operation, Sugammadex 200mg was injected. Suddenly, patient’s oxygen saturation was low at 85%. We started manual ventilation for oxygenation and saturation was increased at 100%. When we extubated endotracheal tube, his ECG changed NSR to idiopathic VT. Firstly we considered that is PSVT and infused adenosine 6mg twice and 12mg once. But arrhythmia was continuous and vital sign changed unstable. We performed reintubation and defibrillated at 200J. After defibrillation, arrhythmia converted sinus rhythm. We transferred the patient to the ICU and evaluated further to see if the patient had heart problems. During admission in ICU, attending surgeon tried to extubate endotracheal tube 2 more times. But, Idiopathic VT occurred whenever try to extubate. Finally, in the fourth attempt, extubation without occurrence of VT succeeded with continuous IV esmolol and dexmedetomidine.
ABSTRACT
Purpose@#This study aims to evaluate the recognition, purchase, and intake status of edible insects in adults, who are the main consumers of edible insects, and to provide the information necessary to expand the production and consumption of edible insects and related products in the future. @*Methods@#A total of 453 adults (172 males and 281 females) aged 19 years and older were surveyed regarding their awareness of edible insects, purchase and consumption experience, and intention to purchase and consume, and the differences between them were analyzed according to gender and age groups. Data collection took place from December 2018 to January 2019. @*Results@#Those who had knowledge of edible insects accounted for 87.0%, whereas those who had more than average knowledge were 75.9%, suggesting recognition was relatively high. Men had more experience than women in purchasing or consuming edible insects and related products (45.9% vs. 31.0%, p < 0.01). In terms of age, experience was 22.5% in 20–30s, 44.6% in 40–50s, and 63.1% in 60s and older, showing significant growth as age increased (p < 0.001). The satisfaction level of edible insects was highest in taste (3.4 points), and especially for shape and appearance, it decreased as age reduced (p < 0.001). The most common reason for not being willing to use edible insects was feeling repulsive (4.1 points), which was significantly more common in women than in men (4.3 vs. 3.9, p < 0.001), and lower with age (p < 0.001). The most needed information display for using edible insects was country of origin (63.8%), the main nutrient in edible insects was protein (93.6%), and the most preferred form of products was powder (39.5%). @*Conclusion@#According to the above results, the recognition of edible insects was high, whereas experience of using edible insects and intention to use edible insects were low especially in women and younger groups. The reason for this is that consumers are dissatisfied with edible insects due to their appearance. This study is expected to be used as basic data for expanding the production and consumption of edible insects and related products in the future.
ABSTRACT
OBJECTIVES: Although water is essential for life and can supply essential minerals, studies that evaluate calcium intake through drinking water are limited. The aim of this study was to assess calcium contents of natural mineral water (NMW) and its possible contribution to calcium intake in healthy adults. METHODS: This study examined water consumption in 640 Korean adults with selfselected diet, analyzed the calcium content of 10 different brands of bottled NMWs sold in Korea, and assessed the amount of calcium intake from drinking water and its daily contribution to the recommended nutrient intake (RNI) of calcium. RESULTS: Mean calcium content in 10 bottled NMWs was 20.9 mg/l. Daily water intakes from food composition database and calculated using energy intake based on 0.53 ml/kcal were 957.2 ml and 1109.8 ml for men and 848.3 ml and 951.6 ml for women, respectively, with a significant difference by gender (p < 0.001). Daily drinking water intake was significantly higher among men than women (1203.9 ml vs. 1004.3 ml, respectively, p < 0.001). Daily calcium intakes from foods were 564.0 mg for men and 534.2 mg for women. Daily possible calcium intakes from drinking bottled water were 25.2 mg for men and 21.0 mg for women (p < 0.001). The contribution of daily calcium intake from drinking bottled water to RNI of calcium was 3.3% for men and 2.9% for women without significant difference. CONCLUSIONS: One half of the daily total water intake was consumed as drinking water, and possible calcium intake through drinking water was about 3% of RNI.
Subject(s)
Adult , Female , Humans , Male , Calcium , Diet , Drinking Water , Drinking , Energy Intake , Korea , Mineral Waters , Minerals , Miners , WaterABSTRACT
OBJECTIVES: The rise of one-person households may have consequences for food consumption patterns, and eating habits. This study investigated the home meal replacement (HMR) use and eating habits among adults in their 20s-30s living in one-person households.METHODS: A total of 247 adults aged 26–39 years participated in this study. The subjects were divided into three group according to the household type; one-person households (n=80), two-person households (n=49), and multi-family (three and more members) households (n=118). Their use of HMRs (classified as ready-to-eat, ready-to-cook, and fresh convenience foods) and their eating habits were all compared.RESULTS: The mean age of the subjects was 30.5 years, 47.8% were male, and there was no significant difference in age, gender, occupation, and monthly income according to the type of household. The intake frequency of total HMR and ready-to-eat foods was significantly higher in one-person households among the three groups. People in one-person households consumed more HMRs alone, and spent more money to buy HMRs. Undesirable dietary habit scores like unbalanced eating (p<0.05) and eating salty foods (p<0.05) were significantly higher in the one-person households. Among the total subjects, the unbalanced eating scores showed a significant positive correlation with the intake frequency of ready-toeat foods, while the unbalanced eating scores showed negative correlation with the preference of fresh convenience foods. The scores for eating salty foods showed a significant positive correlation with the intake frequency and preference of ready-to-eat foods and ready-to-cook foods, while there was negative correlation with the intake frequency and preference of fresh convenience foods.CONCLUSIONS: Adults in their 20s–30s in one-person households consumed more ready-to-eat foods than those in multi-family households. In addition, people with one-person households had more unbalanced diets and ate more salty foods, and these undesirable eating habits showed a significant positive correlation with the use of ready-to-eat or ready-to-cook foods. These results should be addressed for producing healthier ready-to-eat/ready-to-cook foods and implementing nutrition education for making healthy food choices of one-person households, which are steadily increasing.
Subject(s)
Adult , Humans , Male , Diet , Eating , Education , Family Characteristics , Fast Foods , Feeding Behavior , Meals , OccupationsABSTRACT
In video-assisted thoracoscopic surgery (VATS), general anesthesia with endotracheal intubation was considered an optimal method of anesthesia for a long time. However, complications due to general anesthesia and one-lung ventilation have become a problem. In recent years, epidural anesthesia without endotracheal intubation has been attempted in various thoracic surgical procedures with various advantages and disadvantages reported. We compared postoperative pain and prognosis when different anesthesia methods were used in a patient who underwent the same operation twice in the interval of one year. When non-intubated video-assisted thoracoscopic surgery (NIVATS) underwent under epidural anesthesia, postoperative pain score was lower, adverse events were fewer, and the hospital stay was shorter than that of VATS. The patient also expressed high subjective satisfaction. Like previous studies, the results favored NIVATS under epidural anesthesia. However, greater attention and proficiency are required from the anesthesiologist for proper analgesia and sedation.
Subject(s)
Humans , Analgesia , Anesthesia , Anesthesia, Epidural , Anesthesia, General , Intubation , Intubation, Intratracheal , Length of Stay , Methods , One-Lung Ventilation , Pain, Postoperative , Prognosis , Thoracic Surgery, Video-Assisted , Thoracic Surgical ProceduresABSTRACT
Injuries of the larynx are common in patients with a history of inhalation burns. When anesthesia is performed in such patients, the possibility of tracheal intubation should be thoroughly checked in advance, and preparation should be made in case of possible failure. 73-year-old woman who underwent laser cordotomy due to posterior glottic stenosis due to inhalation burn. Her height and weight were 140 cm and 58.9 kg. We proceeded anesthesia, because preoperative fiberoptic laryngoscopy and otolaryngology consultation showed that tracheal intubation was possible. However, the intubation failed and the manual ventilation was not performed afterwards, so the cricothyroidotomy was performed as an emergency. Anesthesia in patients with posterior glottic stenosis due to inhalation burns requires a great deal of attention and, above all, thorough evaluation in order to confirm the possibility of tracheal intubation. If this is not possible, you should look for alternatives and be prepared, and even if you think it's possible, try anesthesia with thorough preparation for the possible failure.
Subject(s)
Aged , Female , Humans , Anesthesia , Burns, Inhalation , Constriction, Pathologic , Cordotomy , Emergencies , Inhalation , Intubation , Laryngoscopy , Larynx , Otolaryngology , VentilationABSTRACT
The purpose of this study was to investigate the relationship between HMR use and eating habits in young Korean adults. This cross-sectional study was conducted on 575 adults (232 men, 343 women) in their 20s and 30s in Korea. Their use of HMRs (classified as ready-to-eat, ready-to-cook, and fresh convenience foods) and eating habits were surveyed. The main reasons for HMR use by men and women were convenience (54.7%, 64.4%) and promptness (24.2%, 24.2%), respectively. The most frequent place for HMR purchase was a convenience store (74.1% and 65.0%, respectively). Regarding the frequency of HMR use, 1~2 times a week was the highest for ready-to-eat (40.9%) and ready-to-cook (30.1%), while no eating was the highest for fresh convenience foods (41.0%). HMR preference was the highest (3.8 out of 5 on a 5-point scale) for ready-to-eat, followed by ready-to-cook (3.3 points) and fresh convenience foods (3.3 points). The use frequency and preference of total HMRs, ready-to-eat foods, and ready-to-eat foods were positively correlated with unfavorable eating habits, including unbalanced eating, overeating, salty eating, spicy eating, skipping, and irregular meals. However, fresh convenience foods showed negative correlations with unbalanced eating, overeating, and salty eating. The use frequency and preference of total HMRs, ready-to-eat foods, and ready-to-cook foods were positively correlated with undesirable eating habits. However, fresh convenience food showed a negative correlation with eating habits such as unbalanced, overeating, and salty eating. These results should be considered for favorable food production and consumer guidance to promote healthy food choices.
Subject(s)
Adult , Female , Humans , Male , Young Adult , Cross-Sectional Studies , Eating , Fast Foods , Hyperphagia , Korea , MealsABSTRACT
OBJECTIVES: Although water is essential for life and can supply essential minerals, studies that evaluate calcium intake through drinking water are limited. The aim of this study was to assess calcium contents of natural mineral water (NMW) and its possible contribution to calcium intake in healthy adults. METHODS: This study examined water consumption in 640 Korean adults with selfselected diet, analyzed the calcium content of 10 different brands of bottled NMWs sold in Korea, and assessed the amount of calcium intake from drinking water and its daily contribution to the recommended nutrient intake (RNI) of calcium. RESULTS: Mean calcium content in 10 bottled NMWs was 20.9 mg/l. Daily water intakes from food composition database and calculated using energy intake based on 0.53 ml/kcal were 957.2 ml and 1109.8 ml for men and 848.3 ml and 951.6 ml for women, respectively, with a significant difference by gender (p < 0.001). Daily drinking water intake was significantly higher among men than women (1203.9 ml vs. 1004.3 ml, respectively, p < 0.001). Daily calcium intakes from foods were 564.0 mg for men and 534.2 mg for women. Daily possible calcium intakes from drinking bottled water were 25.2 mg for men and 21.0 mg for women (p < 0.001). The contribution of daily calcium intake from drinking bottled water to RNI of calcium was 3.3% for men and 2.9% for women without significant difference. CONCLUSIONS: One half of the daily total water intake was consumed as drinking water, and possible calcium intake through drinking water was about 3% of RNI.
Subject(s)
Adult , Female , Humans , Male , Calcium , Diet , Drinking Water , Drinking , Energy Intake , Korea , Mineral Waters , Minerals , Miners , WaterABSTRACT
PURPOSE: Enzyme-linked immunosorbent assay (ELISA) has been used in the diverse field to evaluate influenza virus infection; for the surveillance, diagnosis, efficacy evaluation, and development of the vaccine. The aim of this study was to establish an ELISA for detecting HA strain-specific antibodies using recombinant pandemic A H1N1 (pH1N1) HA1 (rHA1) protein. MATERIALS AND METHODS: rHA1 was produced in baculovirus system. The clinical performance of the developed ELISA was validated using human serum samples, by comparison with standard methods for detecting a neutralizing antibody; hemagglutination inhibition (HI) assay and microneutralization test (MNT). The ability of the ELISA system to evaluate the efficacy test of an influenza vaccine was explored by measuring antibody levels in the serum of vaccinated mice. RESULTS: Our ELISA could detect anti-rHA1 antibody in influenza-infected patients and vaccinated subjects. Compared to HI assay and MNT as reference methods, our method showed good performance in detection of anti-rHA1 antibody. Detection of the anti-rHA1 antibody in vaccinated mice and its correlation with titers in HI assay was also proved in a mice model. CONCLUSION: An ELISA system using rHA1 of pH1N1 influenza virus was developed, and showed good clinical performance in diagnosis of influenza virus infection and evaluation of the vaccination efficacy in both human and animal models.
Subject(s)
Animals , Humans , Mice , Antibodies , Antibodies, Neutralizing , Baculoviridae , Diagnosis , Enzyme-Linked Immunosorbent Assay , Hemagglutination , Influenza A virus , Influenza Vaccines , Influenza, Human , Methods , Models, Animal , Orthomyxoviridae , Pandemics , VaccinationABSTRACT
In video-assisted thoracoscopic surgery (VATS), general anesthesia with endotracheal intubation was considered an optimal method of anesthesia for a long time. However, complications due to general anesthesia and one-lung ventilation have become a problem. In recent years, epidural anesthesia without endotracheal intubation has been attempted in various thoracic surgical procedures with various advantages and disadvantages reported. We compared postoperative pain and prognosis when different anesthesia methods were used in a patient who underwent the same operation twice in the interval of one year. When non-intubated video-assisted thoracoscopic surgery (NIVATS) underwent under epidural anesthesia, postoperative pain score was lower, adverse events were fewer, and the hospital stay was shorter than that of VATS. The patient also expressed high subjective satisfaction. Like previous studies, the results favored NIVATS under epidural anesthesia. However, greater attention and proficiency are required from the anesthesiologist for proper analgesia and sedation.
ABSTRACT
Injuries of the larynx are common in patients with a history of inhalation burns. When anesthesia is performed in such patients, the possibility of tracheal intubation should be thoroughly checked in advance, and preparation should be made in case of possible failure. 73-year-old woman who underwent laser cordotomy due to posterior glottic stenosis due to inhalation burn. Her height and weight were 140 cm and 58.9 kg. We proceeded anesthesia, because preoperative fiberoptic laryngoscopy and otolaryngology consultation showed that tracheal intubation was possible. However, the intubation failed and the manual ventilation was not performed afterwards, so the cricothyroidotomy was performed as an emergency. Anesthesia in patients with posterior glottic stenosis due to inhalation burns requires a great deal of attention and, above all, thorough evaluation in order to confirm the possibility of tracheal intubation. If this is not possible, you should look for alternatives and be prepared, and even if you think it's possible, try anesthesia with thorough preparation for the possible failure.
ABSTRACT
In video-assisted thoracoscopic surgery (VATS), general anesthesia with endotracheal intubation was considered an optimal method of anesthesia for a long time. However, complications due to general anesthesia and one-lung ventilation have become a problem. In recent years, epidural anesthesia without endotracheal intubation has been attempted in various thoracic surgical procedures with various advantages and disadvantages reported. We compared postoperative pain and prognosis when different anesthesia methods were used in a patient who underwent the same operation twice in the interval of one year. When non-intubated video-assisted thoracoscopic surgery (NIVATS) underwent under epidural anesthesia, postoperative pain score was lower, adverse events were fewer, and the hospital stay was shorter than that of VATS. The patient also expressed high subjective satisfaction. Like previous studies, the results favored NIVATS under epidural anesthesia. However, greater attention and proficiency are required from the anesthesiologist for proper analgesia and sedation.
ABSTRACT
Injuries of the larynx are common in patients with a history of inhalation burns. When anesthesia is performed in such patients, the possibility of tracheal intubation should be thoroughly checked in advance, and preparation should be made in case of possible failure. 73-year-old woman who underwent laser cordotomy due to posterior glottic stenosis due to inhalation burn. Her height and weight were 140 cm and 58.9 kg. We proceeded anesthesia, because preoperative fiberoptic laryngoscopy and otolaryngology consultation showed that tracheal intubation was possible. However, the intubation failed and the manual ventilation was not performed afterwards, so the cricothyroidotomy was performed as an emergency. Anesthesia in patients with posterior glottic stenosis due to inhalation burns requires a great deal of attention and, above all, thorough evaluation in order to confirm the possibility of tracheal intubation. If this is not possible, you should look for alternatives and be prepared, and even if you think it's possible, try anesthesia with thorough preparation for the possible failure.
ABSTRACT
This paper reports the effects of neuromuscular electrical stimulation (NMES) when applied to the facial muscles and submental region on a child with dysphagia. The subject was a 5 month girl who had hypoxic brain damage. Two electrodes were applied to the submental region horizontally (6.0 mA) and two electrodes were applied to each side of the mouth (5.0 mA). The child's jaw movement, swallowing food/liquid without excess loss, and swallowing without cough were improved. In addition, she could intake nutrition through the mouth. The result of the level on the Penetration Aspiration Scale (PAS) decreased from 4 to 1, the score on the Behavioral Assessment Scale of Oral Function in Feeding (BASOFF) increased from 13 to 17, and the level on the American Speech Language and Hearing Association: National outcomes measurements system (ASHA NOMS) increased from 1 to 3. When applying NMES to a child with dysphagia, the practitioner should consider various attachment places for improvements in the children's swallowing function.
Subject(s)
Child , Female , Humans , Hypoxia , Cough , Deglutition Disorders , Deglutition , Electric Stimulation , Electrodes , Facial Muscles , Hearing , Hypoxia, Brain , Jaw , MouthABSTRACT
Dietary supplements are popular worldwide and their use has been increasing. The purpose of this study was to evaluate the mineral contents of multi-vitamins and minerals (MVMs) in most commonly sold among dietary supplements. Ninety popular MVM supplements sold in South Korea were surveyed regarding their characteristics and ingredients including minerals listed on the labels through off-line and on-line search. Daily mineral contents of the MVM supplements were compared with Korean Dietary Reference Intakes (DRIs) by target populations. The average price of 90 MVM supplements was $41.3 per bottle, with a price of $0.9 per day and the average number of minerals contained per supplement was 4.7. A total 14 minerals were found in the MVM supplements including calcium, phosphorus, sodium, potassium, and magnesium. Nine minerals (e.g. calcium, magnesium, and iron) were included in more than 30% of the MVM supplements examined. When daily mineral dose of MVMs was compared to DRIs, calcium was the lowest (34.0% of recommended intake [RI]) and chromium was the highest (218.7% of adequate intake [AI]), and zinc, copper, selenium, and chromium were also higher than their RI or AI levels. The daily mineral contents of the 90 MVM supplements were below the tolerable upper-intake level, but some minerals were higher than RI or AI with high variance among products. Therefore, there is a great need to educate the public for the adequate selection and use of MVM supplements based on the contents of MVM supplements and individual's mineral intake derived from the diet.
Subject(s)
Calcium , Chromium , Copper , Diet , Dietary Supplements , Health Services Needs and Demand , Korea , Magnesium , Minerals , Miners , Phosphorus , Potassium , Product Labeling , Recommended Dietary Allowances , Selenium , Sodium , ZincABSTRACT
Transient left bundle branch block (LBBB) is uncommon during anesthesia. It is mainly related to the changes in blood pressure or heart rate. Its occurrence can be confused with acute myocardial ischemia or ventricular tachycardia, therefore differential diagnosis is important. We report a case of transient LBBB which developed with hypoxia during monitored anesthesia care. LBBB is reversed to sinus rhythm after recovery from hypoxia.
Subject(s)
Anesthesia , Hypoxia , Blood Pressure , Bundle-Branch Block , Conscious Sedation , Diagnosis, Differential , Heart Rate , Myocardial Ischemia , Tachycardia, VentricularABSTRACT
BACKGROUND: A prolonged QT interval can lead to malignant ventricular arrhythmias and sudden cardiac death, and has frequently been found in end-stage liver disease (ESLD). However, myocardial repolarization lability has not yet been fully investigated. We evaluated the QT variability index (QTVI), a marker of temporal inhomogeneity in ventricular repolarization and an abnormality associated with re-entrant malignant ventricular arrhythmias. We determined whether QTVI is affected by the head-up tilt test in ESLD. METHODS: We assessed 36 ESLD patients and 12 control subjects without overt heart disease before and after the 70-degree head-up tilt test. The electrocardiography signal (lead II) was recorded on a computer with an analog-to-digital converter. The RR interval (RRI) and QT interval were measured after recording 5 min of the digitized electrocardiography. Then, the QT intervals were corrected with Bazett's formula (QTc). QTVI was calculated through the following formula: QTVI = log10 [(QTv/QTm2)/(RRIv/RRIm2)], QTv/RRIv: variance of QTI/RRI, QTm/RRIm: mean of QT interval/RRI. RESULTS: Cirrhotic patients exhibited an elevated QTVI. In particular, Child class C patients had a significantly increased QTVI compared to Child class A patients and the control subjects in the supine position. However, the head-up tilt test did not cause a significant difference in QTVI in relation to the severity of ESLD. CONCLUSIONS: Myocardial repolarization lability was significantly altered in end-stage liver disease. Our data suggest that the severity of ESLD is associated with the degree of the alteration in the QT variability index.
Subject(s)
Child , Humans , Arrhythmias, Cardiac , Death, Sudden, Cardiac , Electrocardiography , Heart Diseases , Liver Diseases , Liver , Supine PositionABSTRACT
Neurogenic pulmonary edema (NPE) in brain dead organ donors occurring after an acute central nervous system insult threatens organ preservation of potential organ donors and the outcome of organ donation. Hence the active and immediate management of NPE is critical. In this case, a 50-year-old male was admitted to the intensive care unit (ICU) for organ donation. He was hypoxic due to NPE induced by spontaneous intracerebral hemorrhage and intraventricular hemorrhage. Protective ventilatory management, intermittent recruitment maneuvers, and supportive treatment were maintained in the ICU and the operating room (OR). Despite this management, the hypoxemia worsened after the OR admission. So inhaled nitric oxide (NO) therapy was performed during the operation, and the hypoxic phenomena showed remarkable improvement. The organ retrieval was successfully completed. Therefore, NO inhalation can be helpful in the improvement of hypoxemia caused by NPE in brain dead organ donors during anesthesia for the organ donation.