Résumé
Paroxysmal nocturnal hemoglobinuria (PNH) is a rare clonal hematopoietic stem cell disorder. Surgery, anesthesia, infection, trauma, and pregnancy can exacerbate hemolysis and thrombotic risk by increasing complement activity. However, perioperative treatment of eculizumab can reduce risk of hemolytic event by surgical stress. Here, we present the perioperative clinical course and adequate anesthetic management of PNH complicated by spine surgery under general anesthesia. We also describe a possible role of eculizumab for PNH patients with anticipated high risks.
Sujets)
Humains , Grossesse , Anesthésie , Anesthésie générale , Protéines du système du complément , Cellules souches hématopoïétiques , Hémoglobinurie , Hémoglobinurie paroxystique , Hémolyse , Rachis , ThromboseRésumé
Adequate maintenance of body temperature during general anesthesia is necessary for safety. Generally, esophageal temperature probe is commonly used in practice for measuring core temperature because of its reliability and feasibility. Proper placement of esophageal temperature probe is important to avoid complications. In this case report, we describe our experience with a patient undergoing lobectomy of the lung in whom the esophageal temperature probe that was misplaced into the right intermediate bronchus was accidentally cut. This case highlights the need to carefully assess correct position of the temperature probe, especially in patients undergoing one-lung ventilation.