Delayed Obstruction of Endotracheal Tube by Previously Aspirated Foreign Body: A Case Report / 대한구급학회지

Acute airway obstruction during endotracheal intubation status is embarrassing and critical situation which requires early diagnosis and immediate management. Endotracheal tube obstruction with foreign body is rare but a variety of objects have been reported. We present a case of endotracheal tube obstruction as a result of previous aspirated foreign body that moved from the bronchial tree into the endobroncheal tube.

VD/VT and Arterial Blood Gas Changes during Gynecologic Laparoscopic Surgery under Enflurane or Propofol Anesthesia / 대한마취과학회지

BACKGROUND: Laparoscopic gynecologic surgery is a standard procedure today for its small skin incision and short hospital admission stay. However pneumoperitoneum (PP) and Trendelenberg position induce adverse effects in hemodynamics and pulmonary gas exchange. The purpose of this study is to evaluate the effects of propofol compared with enflurane for pulmonary gas exchange in the Trendelenberg position and pneumoperitoneum. METHODS: Twenty women were randomly allocated to either the enflurane (n = 10) or propofol (n = 10) with fentanyl-N2O/O2 anesthesia. PaCO2, PaO2, PETCO2 were checked at pre-PP, 10 min after PP, 30 min after PP, and 10 min after CO2 deflation. In addition the Vd/Vt ratio was calculated according to the Bohr equation. Vital sign and peak airway pressure were checked at each stage. RESULTS: PaCO2 and PETCO2 increased and PaO2 decreased significantly during PP in both groups. Vd/Vt increased significantly in the enflurane group at 30 min after PP. Peak airway pressure increased significantly in both groups. Blood preassure and heart rate were not changed significantly. All of the parameters were not significantly different between groups. CONCLSIONS: Propofol compared with enflurane did not show any advantage in gas exchange during gynecologic laparoscopic surgery under Trendelenberg position and PP.

Decreased Phenytoin Absorption in Patients with Continuous Enteral Feedings / 대한구급학회지

This report supports interactions between phenytoin and both enteral feeding products and nasogastric feeding tube. Five patients in ICU were treated with intravenous phenytoin, which yield detectable therapeutic serum concentrations. After switching to a comparable phenytoin capsule administered by nasogastric feeding tube, their serum phenytoin concentration fell to below assay sensitivity concentrations. Two of them experienced seizures. They were administered by intravenous phenytoin again or another antiepileptic drug, so the seizures were controlled. Some fact of decreased phenytoin absorption in enteral feeding patients is that phenytoin interact enteral feeding product and adhere the nasogastric feeding tube itself. We conclude that it is necessary to use phenytoin with caution in enteral feeding patients.