Risk Factors of Acute Renal Failure after Colorectal Surgery / 영남의대학술지

BACKGROUND: Acute renal failure is one of the leading causes of postoperative morbidity and mortality. The purpose of this study was to determine the risk factors that are associated with acute renal failure after colorectal surgery. MATERIALS AND METHODS: Five hundred seventy patients who operated colorectal surgery at the Yeungnam University Medical Center over three years from 2004 to 2006 were enrolled in this study. The effects of gender, age, ASA classification, concomitant disease, surgery type and duration, reoperation, urogenital manipulation, medication, hypotension, hypovolemia, transfusion, and postoperative ventilatory care on the occurrence of acute renal failure after colorectal surgery were studied. RESULTS: The major risk factors of acute renal failure after colorectal surgery were age of patients (P=0.003), ASA classification (P<0.001), concomitant disease (P<0.001), duration of the time surgery (P=0.034), reoperation (P=0.001), use of intraoperative diuretics (P=0.005), use of postoperative diuretics (P<0.001), intraoperative hypotension (P=0.018), intraoperative transfusion (P<0.001), postoperative transfusion (P<0.001), and postoperative ventilatory care (P=0.001). CONCLUSION: Multiple factors cause synergistic effects on the development of acute renal failure after colorectal surgery. Therefore, efforts to reduce the risk factors associated with acute renal failure are needed. In addition, intensive postoperative care should be provided to all patients.

A case of management of pregnancy in maternal ICH / 대한산부인과학회잡지

A 26-year-old woman presented at 28 weeks' gestation with intracranial hemorrhage, stuporous mentalilty. The pregnancy was maintained with supportive care. At 35+1 weeks' gestation, a 2560 gm, healthy male baby was delivered by means of cesarean section. Maintaining adequate nutritional status is vital in achieving appropriate fetal growth and development. Maternal malnutrition may have an adverse effect on the fetus and neonate, with deleterious effect on birth weight and brain development. When the mother is unconcious, fetal well-being should be assessed by serial biophysical profile scoring. There is no neurosurgical contraindication to vaginal delivery if patient is of good neurologic grade. Nevertheless, cesarean section may be preferable if the patient is in poor neurologic condition.