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김난설 순천향대학교 순천향의학연구소 2021 Journal of Soonchunhyang Medical Science Vol.27 No.2
Catastrophic carbon dioxide (CO2) embolism is a rare, but potentially life-threatening, the complication of laparoscopic gynecologic surgery. We report the case of a healthy 53-year-old woman who developed CO2 embolism and cardiac arrest during laparoscopic surgery. She had a history of two cesarean sections and had extensive peritoneal adhesions. After placement of the trocar and insufflation of CO2, end-tidal CO2 dropped from 35 to 15 mm Hg, and the patient had a cardiovascular collapse. In this patient, CO2 embolism was diagnosed on the basis of a sudden decrease in end-tidal CO2, hypotension, and hypoxemia. The patient was managed quickly and aggressively. The patient recovered completely following the treatment for CO2 embolism, with no cardiopulmonary or neurological sequelae. There is an increased risk of catastrophic CO2 embolism during laparoscopic gynecologic surgery in patients with previous abdominal surgery. Therefore, the surgeon and anesthesiologist should remain vigilant to promote early detection of CO2 embolism.
인슐린 비의존형 당뇨병성 케톤산증 환자의 마취경험 : 증례보고 A case report
강규식,김난설,김지은 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2
The most serious acute complication of DM is diabetic ketoacidosis (DKA). Medical and surgical illnesses account for 50% of episodes of DKA. Infection, myocardial infarction, cerebral vascular accidents, gastrointestinal bleeding, trauma, pancreatitis, and burns are the most common medical causes. The mortality rate from DKA has been reduced to less than 5%. Patients with insulin-dependent diabetes mellitus (IDDM) are more prone to DKA than those with noninsulin-dependent diabetes mellitus (NIDDM). Older diabetics account for approximately 75% of patients who present with DKA. The signs and symptoms of DKA result from hyperglycemia or ketoacidosis. We report a case of anesthetic management of a patient with noninsuline-dependent diabetic ketoacidosis after trauma.