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증례 : 순환기 ; 수술 중 발생한 저체온증에 의한 심실 무수축과 이후 발생한 부정맥
박현진 ( Hyun Jin Park ),손주웅 ( Ju Woong Son ),임규성 ( Kyu Seong Lim ),박철기 ( Choul Ki Park ),박소희 ( So Hee Park ),백승숙 ( Seung Sook Paik ),김우식 ( Woo Shik Kim ) 대한내과학회 2011 대한내과학회지 Vol.81 No.3
저자들은 특이 병력 없는 환자에서 수술 중 저체온에 의해 발생한 심실 무수축과 부정맥을 경험하였기에 이를 보고하는 바이다. A 55-year-old man underwent a posterior decompression and fusion under general anesthesia. Near the end of the operation, the pressure waveform from the radial artery became flat, and his oxygen level could not be measured using pulse oximetry. Palpation of the carotid artery revealed no heart rate, and ventricular asystole was diagnosed. The patient was given cardiovascular drugs, but his hemodynamic status deteriorated, leading to severe hypotension, with sinus bradycardia, sinus tachycardia, sinus arrest, and paroxysmal supraventricular tachycardia. The patient had hypothermia based on an axillary temperature of 31.9℃. After active warming, his cardiovascular status stabilized. (Korean J Med 2011;81:382-386)
급성 천식 발작의 합병증으로 발생한 자발성 종격동기종과 피하기종
손정일 ( Jung Il Son ),김현수 ( Hyun Soo Kim ),최재호 ( Jae Ho Choi ),이은정 ( Eun Jung Lee ),최천웅 ( Cheon Woong Choi ),김이형 ( Yee Hyung Kim ),유지홍 ( Jee Hong Yoo ),장원석 ( Won Seok Jang ),백승숙 ( Seung Sook Paik ),박명재 대한천식알레르기학회 2011 천식 및 알레르기 Vol.31 No.4
Background: Spontanous pneumomediastinum is an uncommon disease that is defined as the nontraumatic presence of free air in the mediastinum without any apparent underlying disease. Asthma is one of the most common health problems, and spontanous pneumomediastinum occurs as a rare complication of acute exacerbation of asthma. Case History: A 29-year-old man with asthma was admitted to the hospital with acute exacerbation of asthma. His respiratory rate was 14 min, and arterial oxgen saturation was 90% at room air. Chest X-ray shows pneumomediastinum and subcutaneous emphysema. Results: He was treated conservatively with oxygen and intravenous steroid therapy, and his clinical conditions improved. Subcutaneous emphysema and pneumomediastinum disappeared during the follow-up period. Conclusion: Spontaneous pneumomediastinum complicated by asthma exacerbation is usually self-limiting and well controlled with conservative management, but this condition can be potentially life threatening. (Korean J Asthma Allergy Clin Immunol 2011;31:307-310)