Journal of Chest Surgery

  • 제37권11호
  • /
  • Pages.922-924
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  • 2004
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  • 2765-1606(pISSN)
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  • 2765-1614(eISSN)
대한심장혈관흉부외과학회 (The Korean Society for Thoracic and Cardiovascular Surgery)
권호 표지

쇼크로 이행한 체외순환 후의 전신성 염증반응 증후군 치험 -1예 보고-

Treatment of Systemic Inflammatory Response Syndrome (SIRS) Following Open Heart Surgery Developed into Shock - A case report-

  • 이동석 (한림대학교 의과대학 흉부외과학교실) ;
  • 신윤철 (한림대학교 의과대학 흉부외과학교실) ;
  • 김응중 (한림대학교 의과대학 흉부외과학교실) ;
  • 지현근 (한림대학교 의과대학 흉부외과학교실)
  • 발행 : 2004.11.01
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초록

호흡곤란을 주소로 55세 남자 환자가 입원하였다. 환자는 급성 심근 경색에 의한 심부전으로 진단 받은 후 체외순환 하에서 관상 동맥 우회술을 시행하였다. 수술 후 1일째 발열, 백혈구 증가증, 빈맥, 빈호흡 등의 증상을 보이기 시작하면서 전신혈관저항이 감소하고 전신성 염증반응 증후군이 발생하면서 쇽으로 이행하였다. 환자는 고용량(36$\mu$g/min)의 norepinephrine으로 치료하였으며 회복되어 퇴원하였다.

A 55 year old male was admitted for dyspnea. The patient was diagnosed as acute myocardiac infarction, and coronary artery bypass grafting was performed with cardiopulmonary bypass. At postoperative day ＃1, Systemic Inflammatory Response Syndrome was developed with fever, leukocytosis, tachycardia, tachypnea and low systemic vascular resistance. The patient was recovered after being treated with high dose of (36 $\mug/min)$ norepinephrine, and was discharged.

키워드

참고문헌

  1. Members of the American College of Chest Physicians/ Society of Critical Care Medicine Consensus Conference Committee. Definition for sepsis and organ failure and guidelines for the innovative therapies in sepsis. Crit Care Med 1992;20:864-74 https://doi.org/10.1097/00003246-199206000-00025
  2. Cremer J, Martin M, Redl H. Systemic inflammatory response syndrome after cardic operation. Ann Thorac Surg 1996;61;1714-20
  3. Rangel-Frausto MS, Pittet D, Costigan M, Hwang T, Davis CS, Wenzel UP. The natural history of the systemic inflammatory response syndrome (SIRS). JAMA 1995;273;117-23.
  4. Beal Al, Cerra FB. Multiple organ failure syndrome in the 1990s. JAMA 1994;268;3452-5
  5. Berger D, Bolke E, Huegel H, et al. New aspects concerning the regulation of the postoperative acute phase reaction during cardiac surgery. Clinica Chimica Acta 1995;239;121-30
  6. Wan S, LeClerc JL, Vincent JL. Inflammatory response to cardiopulmonary bypass: mechanisms involved and possible therapeutic strategies. Chest 1997;112;676-92
  7. Ricardo LL, Marcela AD, Gustavo FB, et al. Methylene blue reduces mortality and morbidity in vasoplegic patients after cardiac surgery. Ann Thorac Surg 2004;77;496-9
  8. Park KH, Choi SC, Han IY, Choi KL, Choi KJ, Cho KH. Relationship between interleukin-6 production and inflammatory response during cardiopulmonary bypass. Korean J Thorac Cardiovasc Surg 2000;33;407-18.