RESUMEN
A 38-year-old female patient had bradycardia in the preoperative electrocardiogram (ECG), and she showed severe bradycardia, with the heart rate (HR) under 40 beats per minute (bpm) even after arrival in the operating room. Immediately after endotracheal intubation, ventricular tachycardia with HR over 200 bpm occurred, but it disappeared voluntarily. The surgery was postponed for additional cardiac evaluation because of the persistent severe bradycardia. On postanesthesia day 2, complete atrioventricular (AV) block appeared. We expected spontaneous recovery over 2 weeks, but the complete AV block persisted. A permanent pacemaker was eventually inserted, and the patient was discharged without other complications on day 4 after insertion of the pacemaker. We report this case because complete AV block has commonly occurred in patients with risk factors such as first AV block, secondary AV block, or bundle branch block, but complete AV block has occurred despite the absence of arrhythmia in this patient.
Asunto(s)
Adulto , Femenino , Humanos , Anestesia General , Arritmias Cardíacas , Bloqueo Atrioventricular , Bradicardia , Bloqueo de Rama , Electrocardiografía , Frecuencia Cardíaca , Intubación Intratraqueal , Quirófanos , Factores de Riesgo , Taquicardia VentricularRESUMEN
BACKGROUND: Liver transplantation (LT) is a complicated procedure with a high incidence of postoperative acute kidney injury (AKI). Previous studies indicate that even transient or mild post-LT AKI can result in critical conditions, including prolonged stays in hospitals and intensive care units and increased morbidity and mortality. The aim of this study was to investigate the association between body mass index (BMI) and occurrence of AKI in LT recipients. METHODS: Medical data from 203 patients who received LT surgery from January 2010 to August 2016 in a single university hospital setting were retrospectively collected and analyzed. Patients were classified as either underweight (BMI <20 kg/m²) or normal weight (20 ≤ BMI < 30 kg/m²). Demographic data, anesthetic methods, complications, and perioperative laboratory test values of each patient were assessed. Propensity analyses and logistic regression were performed to evaluate the association between BMI and post-LT AKI. RESULTS: There was no significant difference in occurrence of post-LT AKI between underweight and normal weight patients. The underweight patient group had significantly longer hospital stay compared with the normal weight patient group (P = 0.023). CONCLUSIONS: BMI classification was neither a positive nor negative predictor of postoperative AKI occurrence. However, patients with lower BMI had significantly longer hospital stay compared with their counterparts. Although our study was limited by its retrospective design, our observations suggest that lower BMI might play a role in post-LT AKI.
Asunto(s)
Humanos , Lesión Renal Aguda , Índice de Masa Corporal , Clasificación , Incidencia , Unidades de Cuidados Intensivos , Tiempo de Internación , Trasplante de Hígado , Hígado , Modelos Logísticos , Mortalidad , Estudios Retrospectivos , DelgadezRESUMEN
BACKGROUND: Liver transplantation (LT) is a complicated procedure with a high incidence of postoperative acute kidney injury (AKI). Previous studies indicate that even transient or mild post-LT AKI can result in critical conditions, including prolonged stays in hospitals and intensive care units and increased morbidity and mortality. The aim of this study was to investigate the association between body mass index (BMI) and occurrence of AKI in LT recipients. METHODS: Medical data from 203 patients who received LT surgery from January 2010 to August 2016 in a single university hospital setting were retrospectively collected and analyzed. Patients were classified as either underweight (BMI <20 kg/m²) or normal weight (20 ≤ BMI < 30 kg/m²). Demographic data, anesthetic methods, complications, and perioperative laboratory test values of each patient were assessed. Propensity analyses and logistic regression were performed to evaluate the association between BMI and post-LT AKI. RESULTS: There was no significant difference in occurrence of post-LT AKI between underweight and normal weight patients. The underweight patient group had significantly longer hospital stay compared with the normal weight patient group (P = 0.023). CONCLUSIONS: BMI classification was neither a positive nor negative predictor of postoperative AKI occurrence. However, patients with lower BMI had significantly longer hospital stay compared with their counterparts. Although our study was limited by its retrospective design, our observations suggest that lower BMI might play a role in post-LT AKI.
Asunto(s)
Humanos , Lesión Renal Aguda , Índice de Masa Corporal , Clasificación , Incidencia , Unidades de Cuidados Intensivos , Tiempo de Internación , Trasplante de Hígado , Hígado , Modelos Logísticos , Mortalidad , Estudios Retrospectivos , DelgadezRESUMEN
The goal of treatment in OME is normal aerated middle ear space. When the tympanogram convert to type A or C from type B in patients with OME, no further medication would be needed. But 1/3 of these patient had type B tympanogram again after 4 weeks follow up without medication. Many parameters-including age, sex, season, unilaterality, passive smoking, associated rhinitis etc-were concerned about the recurrence of OME. Ultra high frequency audiometry was added as a new parameter in recurrence of OME.