[Recovery from out-of-hospital cardiac arrest after mild hypothermia: report of two cases].

We report two patients with out-of-hospital cardiac arrest who recovered after hypothermia therapy. A 25-year-old man and a 16-year-old boy were transferred to our hospital after cardiopulmonary arrest due to idiopathic ventricular fibrillation and hypertrophic cardiomyopathy, respectively. We carried out hypothermia therapy using cooling blankets, and the patients were maintained at 32-33 degrees C for 96 and 36 h, respectively. After slow rewarming, they regained consciousness and recovered. During hypothermia, hypokalemia and arrhythmia occurred. Their arrest times (no spontaneous circulation and no CPR) were 10 min and 8 min, and CPR times (no spontaneous circulation while CPR was being performed) were 24 min and 20 min, respectively. In cases where the duration of ischemia is prolonged, the prognosis is expected to be poor. Therefore, we believe that hypothermia therapy is beneficial for such patients.

[Anesthetic management of a patient with perforated necrotic trachea after radical esophageal cancer surgery].

We anesthetized a 69-year-old man with perforated necrotic trachea after radical esophageal cancer surgery. We recognized during the reoperation that necrotizing part of the trachea was perforated from the cricoid cartilage to 2cm above the carina. We ventilated the both lungs successfully without leaks by inserting a double-lumen tube into the trachea after tracheostomy. Postoperatively, the carina and the main bronchi were also necrotized and perforated. We ventilated the both lungs without leaks by inserting two single-lumen tubes into the left and right bronchi separately. But, eventually the distal part of the both bronchi was also necrotized and perforated. Finally, the patient died of respiratory failure due to hypoventilation on the 7th day after the re-operation. We should remember this type of emergency complication after radical esophageal cancer surgery.