アクセス数 : ?
ダウンロード数 : ?
ID 109603
著者
富山, 芳信 Division of Surgical Center, Tokushima University Hospital, the University of Tokushima 徳島大学 教育研究者総覧 KAKEN研究者をさがす
ヒガシジマ, サチヨ Department of Anesthesiology, Tokushima University Hospital, the University of Tokushima
カドタ, タカコ Department of Anesthesia, Takamatsu Red Cross Hospital
久米, 克佳 Department of Anesthesiology, Tokushima University Hospital, the University of Tokushima KAKEN研究者をさがす
カワハラ, トミヤ Department of Anesthesiology, Tokushima University Hospital, the University of Tokushima
オオシタ, ナオヒロ Department of Anesthesiology, Tokushima University Hospital, the University of Tokushima
キーワード
electrocardiogram
pneumothorax
R-wave amplitude
資料タイプ
学術雑誌論文
抄録
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.
掲載誌名
The journal of medical investigation : JMI
ISSN
13431420
cat書誌ID
AA11166929
61
3-4
開始ページ
442
終了ページ
445
並び順
442
発行日
2014-08
EDB ID
フルテキストファイル
言語
eng
著者版フラグ
出版社版
部局
病院