ID 109603
Author
Tomiyama, Yoshinobu Division of Surgical Center, Tokushima University Hospital, the University of Tokushima Tokushima University Educator and Researcher Directory KAKEN Search Researchers
Higashijima, Sachiyo Department of Anesthesiology, Tokushima University Hospital, the University of Tokushima
Kadota, Takako Department of Anesthesia, Takamatsu Red Cross Hospital
Kume, Katsuyoshi Department of Anesthesiology, Tokushima University Hospital, the University of Tokushima KAKEN Search Researchers
Kawahara, Tomiya Department of Anesthesiology, Tokushima University Hospital, the University of Tokushima
Ohshita, Naohiro Department of Anesthesiology, Tokushima University Hospital, the University of Tokushima
Keywords
electrocardiogram
pneumothorax
R-wave amplitude
Content Type
Journal Article
Description
Tension pneumothorax is a rare but potentially life-threating complication of laparoscopic fundoplication. Electrocardiogram (ECG) changes may be used in the diagnosis of intraoperative tension pneumothorax. This case study examines a pediatric patient who underwent laparoscopic fundoplication. Sudden decreases in oxygen saturation were observed during dissection, although the patient’s decrease in blood pressure was less marked. Manual ventilation with high inspiratory pressure and inspiratory pause improved oxygenation. The amplitude of the R-wave decreased from 0.8 mV to 0.3mV in 5 seconds. Twenty minutes later, oxygen saturation decreased again, the R-wave amplitude decreased from 0.3 mV to 0.1 mV in 1 second, and the decrease in blood pressure was marked. Manual ventilation with high inspiratory pressure improved oxygenation, blood pressure, and R-wave amplitude within two minutes. After conversion to open surgery, the cardiorespiratory condition gradually improved, but the R-wave amplitude did not fully recover, even at the end of surgery. Right-side pneumothorax was subsequently confirmed by postoperative chest X-ray. Chest drains were inserted after surgery. This case suggests that trends in R-wave amplitude are potential indicators of intraoperative tension pneumothorax.
Journal Title
The journal of medical investigation : JMI
ISSN
13431420
NCID
AA11166929
Volume
61
Issue
3-4
Start Page
442
End Page
445
Sort Key
442
Published Date
2014-08
EDB ID
FullText File
language
eng
TextVersion
Publisher
departments
University Hospital