Obstruction of Airway Filter/Heat and Moisture Exchanger during Cardiac Surgery: A case report / 대한마취과학회지

An acute obstruction of the breathing circuit during surgery can be a devastating situation. A 45-year old man who diagnosed with infective endocarditis and aortic valve regurgitation underwent emergency cardiac surgery. However, an obstruction of the breathing circuit occurred when the cardiopulmonary bypass was weaned. Fortunately, the ventilation normalized after removing the airway filter/heat and moisture exchanger (HME). We report this case of a HME obstruction of the breathing circuit with a review of the relevant literature.

Nonlinear Analysis of Heart Rate Variability: Possible Predictor for Atrial Fibrillation after Coronary Artery Bypass Graft (CABG) Surgery / 대한구급학회지

BACKGROUND: Heart Rate Variability (HRV) is a valuable marker of autonomic tone and may assist evaluating the prognosis in patients with heart disease. The purpose of this study was to assess whether preoperative heart rate variability analysis predicts atrial fibrillation in patients undergoing coronary artery bypass graft (CABG) surgery. METHODS: This study was designed as a prospective observational study. After IRB approval was obtained by our institution, 76 patients scheduled for elective CABG surgery underwent a 10-min electrocardiogram recordings 1~2 hours prior to surgery. Heart rate variability analysis was performed with spectral analysis and point correlation dimension. RESULTS: There was no significant difference in the low and high frequency component (LF/HF) ratio preoperatively between patients with atrial fibrillation and patients with normal sinus rhythm postoperatively (3.0+/-2.45, 4.25+/-3.70, p=0.085). Baseline peak point correlation dimension (pPD2) was significantly higher in patients with atrial fibrillation than in patients with normal sinus rhythm postoperatively (4.2+/-0.8, 3.8+/-0.7, p=0.042). CONCLUSIONS: Patients who developed atrial fibrillation postoperatively had a higher baseline pPD2 value preoperatively. Point correlation dimensions may predict the occurrence of postoperative atrial fibrillation after CABG surgery. However, further studies are needed to confirm whether point correlation dimensions are an effective predictor for postoperative atrial fibrillation.