RESUMO
Case 1:A 59-year-old man underwent mitral valve replacement and Maze operation.Under general anesthesia, a pulmonary artery catheter (PAC) and superior vena cava (SVC) cannula were inserted.There were no complications during surgery.However, when the surgeons attempted to remove the PAC the next day there was resistance that caused the catheter to break during removal.A chest X ray revealed that the distal portion of the PAC remained in his heart.Therefore, the patient underwent surgery to remove the remnant catheter.Case 2:A 62-year-old man underwent mitral valvuloplasty.A PAC was inserted under general anesthesia.After the procedure, the patient was weaned off his cardiopulmonary bypass (CPB).However, his pulmonary artery pressure could not be measured and an abnormal wave was observed. We attempted to re-insert the catheter, but were unsuccesful.An operation was conducted and the catheter was found to be tied at the septum of the right atrium.
Assuntos
Humanos , Pessoa de Meia-Idade , Anestesia Geral , Ponte Cardiopulmonar , Catéteres , Valva Mitral , Artéria Pulmonar , Tórax , Veia Cava SuperiorRESUMO
Case 1:A 59-year-old man underwent mitral valve replacement and Maze operation.Under general anesthesia, a pulmonary artery catheter (PAC) and superior vena cava (SVC) cannula were inserted.There were no complications during surgery.However, when the surgeons attempted to remove the PAC the next day there was resistance that caused the catheter to break during removal.A chest X ray revealed that the distal portion of the PAC remained in his heart.Therefore, the patient underwent surgery to remove the remnant catheter.Case 2:A 62-year-old man underwent mitral valvuloplasty.A PAC was inserted under general anesthesia.After the procedure, the patient was weaned off his cardiopulmonary bypass (CPB).However, his pulmonary artery pressure could not be measured and an abnormal wave was observed. We attempted to re-insert the catheter, but were unsuccesful.An operation was conducted and the catheter was found to be tied at the septum of the right atrium.
Assuntos
Humanos , Pessoa de Meia-Idade , Anestesia Geral , Ponte Cardiopulmonar , Catéteres , Valva Mitral , Artéria Pulmonar , Tórax , Veia Cava SuperiorRESUMO
BACKGROUND: A brief episode of cerebral ischemia confers transient ischemic tolerance to a subsequent ischemic challenge that is otherwise lethal to them. This study was purposed to evaluate the effect of mitochondrial adenosine triphosphate-sensitive potassium (KATP) channel blocker on ischemic preconditioning in hypoxic-ischemic brain injury model of neonatal rat. METHODS: Seven-day old Sprague-Dawley rat pups were used. The rats were divided into five groups; control group (n = 91), pretreatment hypoxic preconditioning group (n = 43), pretreatment ischemic preconditioning group (n = 52), hypoxic preconditioning group (n = 39), and ischemic preconditioning group (n = 51). Rats in the pretreatment hypoxic preconditioning group and pretreatment ischemic preconditioning group were treated by an intraperitoneal injection with 5-hydroxydecanoate (60 mg/kg). Thirty minutes after injection, right common carotid artery was temporarily occluded for ten minutes in pretreatment ischemic preconditioning group. Rats in the pretreatment hypoxic preconditioning group and hypoxic preconditioning group underwent hypoxia (8% oxygen/92% nitrogen) for four hours. Twenty-four hours after the preconditioning, rats from all groups were exposed to right common carotid artery ligation followed by 2.5 hour hypoxia. On the 1st day after hypoxic-ischemic brain injury, terminal deoxynucleotidyltransferase-mediated dUTP-biotin nick end-labeling (TUNEL) reaction was evaluate as apoptotic markers and triphenyl tetrazolium chloride (TTC) was done to measure necrotic tissue. All rats were sacrificed 2 weeks after hypoxic-ischemia brain injury and the brains were examined for morphologic study. RESULTS: There were no differenced in survival rate, infarct area, number of TUNEL positive cells and morphologic score either between hypoxic preconditioning group and pretreatment hypoxic preconditioning group or between ischemic preconditioning group and pretreatment ischemic preconditioning group. CONCLUSIONS: The results suggests that mitochondrial K(ATP) channel blocker, 5-hydroxydecanoate, does not change hypoxic-ischemic preconditioning in the neonatal rat.
Assuntos
Animais , Ratos , Adenosina , Hipóxia , Encéfalo , Lesões Encefálicas , Isquemia Encefálica , Artéria Carótida Primitiva , Ácidos Decanoicos , Hidroxiácidos , Marcação In Situ das Extremidades Cortadas , Injeções Intraperitoneais , Precondicionamento Isquêmico , Ligadura , Potássio , Canais de Potássio , Taxa de SobrevidaRESUMO
Difficulties in ventilation are sometimes encountered in intubated patients. In these cases, endotracheal tube kinking, or an obstruction by secretion or foreign bodies should be considered. We experienced an endotracheal tube obstruction by a foreign body. The patient was a 36 year old woman who had a traffic accident. She had already been intubated when entering operating room. However, ventilation was difficult, which was presumed to be caused by an endotracheal tube obstruction. The endotracheal tube was examined by fiberoptic bronchoscopy and the patient's broken tooth was found inside the endotracheal tube. The endotracheal tube was exchanged and ventilation was normalized.