Prolonged post-reperfusion syndrome during multivisceral organ transplantation in a pediatric patient: a case report / 대한마취과학회지

Multivisceral organ transplantation involves the transplantation of three or more abdominal organs, including small bowel, duodenum, stomach, liver, pancreas, colon, and so on. The large amounts of cold and acidic loading into systemic circulation from the graft during multivisceral organ transplantation may result in severe post-reperfusion syndrome (PRS). We describe here a 6-year-old pediatric patient with chronic intestinal pseudo-obstruction who experienced prolonged PRS and severe metabolic acidosis during seven abdominal organ transplantation including the liver, spleen, stomach, duodenum, small bowel, colon and pancreas. The hypotensive period lasted approximately 10 minutes after graft reperfusion and was accompanied by severe metabolic acidosis and hypothermia. Since PRS can be easily associated with adverse outcomes, such as poor early graft function and primary non-function, not only meticulous surveillance for aggravating factors for PRS but also their immediate correction were necessary in managing a pediatric patient undergoing multivisceral organ transplantation.

Transient adenosine-induced asystole in the surgical treatment of intracranial aneurysms: A report of two cases

Advances in anesthetic and surgical management, such as deep hypothermic circulatory arrest and temporary clipping, have improved outcomes for intracranial aneurysm patients. However, these techniques are associated with significant risks. We report on two cases in which adenosine administration was used to induce transient periods of cardiac asystole during intracranial aneurysm surgery. This asystole resulted in profound hypotension and collapse of the aneurysm, which facilitated its safe clipping.

Protective effects of propofol against hydrogen peroxide-induced oxidative stress in human kidney proximal tubular cells / 대한마취과학회지

BACKGROUND: We investigated the protective effects of propofol in the HK-2 cell line of human kidney proximal tubular cells against hydrogen peroxide (H2O2)-induced oxidative stress. METHODS: After pretreatment with different concentrations of propofol (0 microM, 10 microM, 25 microM and 50 microM) for 30 minutes, HK-2 cells were exposed to 8 mM H2O2 for 4 hours. Cell death was assessed by measuring the percentage of lactate dehydrogenase (LDH) release and by counting viable cells. The nature of cell death was assessed by doubles-taining cells with fluorescein isothiocyanate-labeled Annexin V and propidium iodide, and then analyzing the cells using flow cytometry. RESULTS: After exposure to 8 mM H2O2 for 4 hours, the percentage of LDH release was 45.1 +/- 4.2% and the number of viable HK-2 cells was 5.2 +/- 6.0%. Pretreatment with propofol suppressed H2O2-induced LDH release in a concentration-dependent manner, reducing the percentage of LDH release to 38.1 +/- 5.6%, 33.5 +/- 6.3%, and 26.2 +/- 3.8% of the controls at 10 microM, 25 microM and 50 microM propofol, respectively. Numbers of viable cells increased following propofol pretreatment, with 11.4 +/- 10.9%, 19.5 +/- 16.1%, and 32.4 +/- 23.3% cell survival rates after pretreatment with 10 microM, 25 microM and 50 microM propofol, respectively. Analyses of flow cytometry showed that the propofol pretreatment decreased the percentage of necrotic and late apoptotic cells. CONCLUSIONS: Propofol protects HK-2 human kidney proximal tubular cells against H2O2-induced oxidative stress.