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선천성 기관식도루 환자에서 식도를 통한 기관내삽관 -증례보고-
정진헌 ( Jin Hun Chung ),송상우 ( Sang Woo Song ),안기량 ( Ki Ryang Ahn ),김천숙 ( Chun Sook Kim ),강규식 ( Kyu Sik Kang ),유시현 ( Sie Hyeon Yoo ),정지원 ( Ji Won Chung ),구자욱 ( Ja Ug Koo ) 대한마취과학회 2009 Korean Journal of Anesthesiology Vol.56 No.6
H type of congenital tracheoesophageal fistula (TEF) is rare, occurring approximately once in 100,000 births. The presentation of this anomaly in adults is indeed uncommon. We report a case of a 47-year-old male with congenital TEF dectected during epidural hematoma removal under general anesthesia. Intermittent disappearance of normal capnography, bubbling sound at substernal area, and air leakage at oral cavity observed during manually assisted ventilation, especially during inspiration. We observed a H-type of TEF and tracheal intubation via esophagus in chest CT after operation. (Korean J Anesthesiol 2009; 56: 698~702)
소아에서 진단 복강경술과 복강경하 수술 시 심폐기능 변화
정진헌 ( Jin Hun Chung ),안기량 ( Ki Ryang Ahn ),신온섭 ( On Sub Shin ),김천숙 ( Chun Sook Kim ),강규식 ( Kyu Sik Kang ),유시현 ( Sie Hyeon Yoo ),정지원 ( Ji Won Chung ),구자욱 ( Ja Ug Koo ),이정석 ( Jeong Seok Lee ) 대한마취과학회 2009 Korean Journal of Anesthesiology Vol.56 No.1
Background: Information concerning the cardiopulmonary effects of pneumoperitoneum in children is lacking. Methods: Twenty eight patients were assigned to receive diagnostic laparoscopy (n=12) or laparoscopic surgery (n=16). Before insufflation of CO2, tidal volume was set at 10 ml/kg and respiratory rate was adjusted to achieve an end-tidal CO2 (P(ET)CO2) of 30-35 mmHg. Abdominal pressure was maintained at 10-15 mmHg by a CO2 insufflator. We measured the changes of systolic arterial pressure (SAP), heart rate (HR), P(ET)CO2 and peak airway pressure (PAP) at 5 min before (control value) and after CO2 insufflation and 5 min after CO2 deflation. Results: SAP and PAP were increased significantly after pnemoperitoneum compared with the control both in diagnostic laparoscopy and laparoscopic surgery (P<0.05). P(ET)CO2 was increased significantly after pneumoperitoneum and after CO2 deflation in laparoscopic surgery compared with the control and also with diagnostic laparoscopy (P<0.05). Driving pressure (the difference between peak airway pressure and abdominal pressure) was increased significantly after pneumoperitoneum in laparoscopic surgery compared with diagnostic laparoscopy (P<0.05). Conclusions: SAP, PAP and P(ET)CO2 increases during diagnostic laparoscopy and laparoscopic surgery, but this effect appears to be of smaller magnitude in diagnostic laparoscopy compared to laparoscopic surgery. We found that these changes had no clinically deleterious effects in healthy children. (Korean J Anesthesiol 2009;56:31~5)
기관내 삽관 후 발생한 기관 괴사와 협착증 : 증례보고 A case report
권진형,구자욱,유시현 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2
Tracheal necrosis and stenosis are rare complications of prolonged endotracheal intubation. A 62 years old female was performed cerebral aneurysmal neck clipping under general anesthesia via endotracheal intubation and transferred to the 12th intensive care unit. The patient was mechanically ventilated and tracheostomy was done on the postoperative day. Necrotic tissue, pus and stenosis were found around the ballooning site of the trachea. T-tube insertion was done on the both postoperative day and the patient was discharged on the 80th postoperative day.