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      • KCI등재

        Association of the perfusion index with postoperative acute kidney injury: a retrospective study

        Kang Pyoyoon,Park Jung-bin,Yoon Hyun-Kyu,Ji Sang-Hwan,Jang Young-Eun,Kim Eun-Hee,Lee Ji-Hyun,Lee Hyung-Chul,김진태,김희수 대한마취통증의학회 2023 Korean Journal of Anesthesiology Vol.76 No.4

        Background: Many studies have examined the risk factors for postoperative acute kidney injury (AKI), but few have focused on intraoperative peripheral perfusion index (PPI) that has recently been shown to be associated with postoperative morbidity and mortality. Therefore, this study aimed to evaluate the relationship between intraoperative PPI and postoperative AKI under the hypothesis that lower intraoperative PPI is associated with AKI occurrence.Methods: We retrospectively searched electronic medical records to identify patients who underwent surgery at the general surgery department from May 2021 to November 2021. Patient baseline characteristics, pre- and post-operative laboratory test results, comorbidities, intraoperative vital signs, and discharge profiles were obtained from the Institutional Clinical Data Warehouse and VitalDB. Intraoperative PPI was the primary exposure variable, and the primary outcome was postoperative AKI.Results: Overall, 2,554 patients were identified and 1,586 patients were included in our analysis. According to Kidney Disease Improving Global Outcomes (KDIGO) criteria, postoperative AKI occurred in 123 (7.8%) patients. We found that risks of postoperative AKI increased (odds ratio: 2.00, 95% CI [1.16, 3.44], P = 0.012) when PPI was less than 0.5 for more than 10% of surgery time. Other risk factors for AKI occurrence were male sex, older age, higher American Society of Anesthesiologists physical status, obesity, underlying renal disease, prolonged operation time, transfusion, and emergent operation.Conclusions: Low intraoperative PPI was independently associated with postoperative AKI.

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        Usefulness of C-curved stylet for intubation with the C-MAC® Miller videolaryngoscope in neonates and infants: a prospective randomized controlled trial

        Park Jung-bin,Kang Pyoyoon,Kim Taeyup,Ji Sang-Hwan,Jang Young-Eun,Kim Eun-Hee,Kim Jin-Tae,김희수,이지현 대한마취통증의학회 2023 Korean Journal of Anesthesiology Vol.76 No.5

        Background: Optimizing endotracheal tube (ETT) shape is important for successful videolaryngoscope-aided intubation. This prospective randomized controlled study aimed to compare the tube-handling time between a C-curved and hockey stick-shaped stylet in infants and neonates using the C-MAC® videolaryngoscope Miller blade.Methods: A total of 110 infants (age < 1 year) were randomly assigned to either the hockey stick-curved stylet group (group H, n = 53) or the C-curved stylet group (group C, n = 57). The primary outcome was tube handling time after glottis visualization and the secondary outcomes were the total intubation time, incidence of successful intubation, initial tube tip location at the laryngeal inlet, and numerical rating scale for ease of intubation. Results: Tube insertion time and total intubation duration (both in seconds) were significantly shorter in group C than in group H (13.3 ± 8.9 vs. 25.1 ± 27.0, P = 0.002; 19.9 ± 9.4 vs. 32.8 ± 27.1, P = 0.001, respectively). Group C displayed a higher rate of intubation success within 30 s than group H (87.7% vs. 69.8%, P = 0.029). The initial tube tip was located at the center in 34 children in group C (59.6%) and 12 children in group H (26.1%, P < 0.001). Laryngoscope operators rated intubation as easier when provided with a C-curved stylet.Conclusions: In neonates and infants, modification of the ETT shape into a C-curve may reduce tube handling time compared to the conventional hockey stick-shaped tube during intubation using a C-MAC® video laryngoscope Miller blade.

      • KCI등재

        Perioperative Respiratory-Adverse Events Following General Anesthesia Among Pediatric Patients After COVID-19

        Park Jung-Bin,Sohn Jin Young,Kang Pyoyoon,Ji Sang-Hwan,Kim Eun-Hee,Lee Ji-Hyun,Kim Jin-Tae,Kim Hee-Soo,Jang Young-Eun 대한의학회 2023 Journal of Korean medical science Vol.38 No.47

        Background: The perianesthetic morbidity, mortality risk and anesthesia-associated risk after preoperative coronavirus disease 2019 (COVID-19) omicron variant in pediatric patients have not been fully demonstrated. We examined the association between preoperative COVID-19 omicron diagnosis and the incidence of overall perioperative adverse events in pediatric patients who received general anesthesia. Methods: This retrospective study included patients aged < 18 years who received general anesthesia between February 1 and June 10, 2022, in a single tertiary pediatric hospital. They were divided into two groups; patients in a COVID-19 group were matched to patients in a non-COVID-19 group during the omicron-predominant period in Korea. Data on patient characteristics, anesthesia records, post-anesthesia records, COVID-19-related history, symptoms, and mortality were collected. The primary outcomes were the overall perioperative adverse events, including perioperative respiratory adverse events (PRAEs), escalation of care, and mortality. Results: In total, 992 patients were included in the data analysis (n = 496, COVID-19; n = 496, non-COVID-19) after matching. The overall incidence of perioperative adverse events was significantly higher in the COVID-19 group than in the non-COVID-19 group (odds ratio [OR], 1.92; 95% confidence interval [CI], 1.89–1.94). The difference was significant for PRAEs (OR, 2.00; 95% CI, 1.96–2.02) but not in escalation of care or mortality. The most pronounced difference between the two groups was observed in instances of high peak inspiratory pressure ≥ 25 cmH2O during the intraoperative period (OR, 11.0; 95% CI, 10.5–11.4). Compared with the non-COVID-19 group, the risk of overall perioperative adverse events was higher in the COVID-19 group diagnosed 0–2 weeks before anesthesia (OR, 6.5; 95% CI, 2.1–20.4) or symptomatic on the anesthesia day (OR, 6.4; 95% CI, 3.30–12.4). Conclusion: Pediatric patients with the preoperative COVID-19 omicron variant had increased risk of PRAEs. Patients within 2 weeks after COVID-19 or those with symptoms had a higher risk of PRAEs.

      • KCI등재

        Airway management of a patient incidentally diagnosed with Mounier-Kuhn syndrome during general anesthesia

        No, Hyun-Joung,Lee, Jung-Man,Won, Dongwook,Kang, Pyoyoon,Choi, Seungeun The Korean Dental Society of Anesthsiology 2019 Journal of Dental Anesthesia and Pain Medicine Vol.19 No.5

        Mounier-Kuhn syndrome (MKS) is a disease characterized by dilation of the trachea and mainstem bronchi. Due to the risk of airway leakage, pulmonary aspiration, and tracheal damage, MKS can be fatal in patients undergoing tracheal intubation. Moreover, MKS may not be diagnosed preoperatively due to its rarity. In this case, a patient undergoing neurosurgery was incidentally diagnosed with MKS during general anesthesia. During anesthesia induction, difficulties in airway management led the anesthesiologist to suspect MKS. Airway leakage was resolved in this case using oropharyngeal gauze packing. Anesthesiologists should be aware of the possibility of MKS and appropriate management of the airways.

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