The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
권호 표지

Ventricular Asystole and Arrhythmia during Surgery Provoked by Profound Hypothermia

수술 중 발생한 저체온증에 의한 심실 무수축과 이후 발생한 부정맥

  • Park, Hyun-Jin (Division of Cardiology, Department of Internal Medicine, Kyung Hee University School of Medicine) ;
  • Son, Ju-Woong (Division of Cardiology, Department of Internal Medicine, Kyung Hee University School of Medicine) ;
  • Lim, Kyu-Seong (Division of Cardiology, Department of Internal Medicine, Kyung Hee University School of Medicine) ;
  • Park, Choul-Ki (Division of Cardiology, Department of Internal Medicine, Kyung Hee University School of Medicine) ;
  • Park, So-Hee (Division of Cardiology, Department of Internal Medicine, Kyung Hee University School of Medicine) ;
  • Paik, Seung-Sook (Division of Cardiology, Department of Internal Medicine, Kyung Hee University School of Medicine) ;
  • Kim, Woo-Shik (Division of Cardiology, Department of Internal Medicine, Kyung Hee University School of Medicine)
  • 박현진 (경희대학교 의학전문대학원.의과대학 내과학교실) ;
  • 손주웅 (경희대학교 의학전문대학원.의과대학 내과학교실) ;
  • 임규성 (경희대학교 의학전문대학원.의과대학 내과학교실) ;
  • 박철기 (경희대학교 의학전문대학원.의과대학 내과학교실) ;
  • 박소희 (경희대학교 의학전문대학원.의과대학 내과학교실) ;
  • 백승숙 (경희대학교 의학전문대학원.의과대학 내과학교실) ;
  • 김우식 (경희대학교 의학전문대학원.의과대학 내과학교실)
  • Published : 2011.09.01
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Abstract

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 $31.9^{\circ}C$. After active warming, his cardiovascular status stabilized.

저자들은 특이 병력 없는 환자에서 수술 중 저체온에 의해 발생한 심실 무수축과 부정맥을 경험하였기에 이를 보고하는 바이다.

Keywords

References

  1. Huszar RJ. Basic Dysrhythmias. 3rd ed. St. Louis: Mosby-Year Book, 2002.
  2. Kahn HA, Faust GR, Richard R, Tedesco R, Cohen JR. Hypothermia and bleeding during abdominal aortic aneurysm repair. Ann Vasc Surg 1994;8:6-9. https://doi.org/10.1007/BF02133399
  3. Oh YL, Kim HI, Um MS, et al. Two cases of hypothermia with Osborne's J wave on ECG. Korean J Med 2000;59:561-564.
  4. Lee SY. The effects of hypothermia on exocrine pancreatic and Biliary Secretion. Korean J Med 1965;8:381-395.
  5. Kurz A, Sessler DI, Lenhardt R. Perioperative normothermia to reduce the incidence of surgical-wound infection and shorten hospitalization: study of Wound Infection and Temperature Group. N Engl J Med 1996;334:1209-1215. https://doi.org/10.1056/NEJM199605093341901
  6. Benzinger TH. Heat regulation: homeostasis of central temperature in man. Physiol Rev 1969;49:671-759.
  7. Doufas AG. Consequences of inadvertent perioperative hypothermia. Best Pract Res Clin Anaesthesiol 2003;17:535-549. https://doi.org/10.1016/S1521-6896(03)00052-1
  8. Mattu A, Brady WJ, Perron AD. Electrocardiographic manifestations of hypothermia. Am J Emerg Med 2002;20:314-326. https://doi.org/10.1053/ajem.2002.32633
  9. Maruyama M, Kobayashi Y, Kodani E, et al. Osborn waves: history and significance. Indian Pacing Electrophysiol J 2004;4:33-39.
  10. Yu CG, Jimenez O, Marcillo AE, et al. Beneficial effects of modest systemic hypothermia on locomotor function and histopathological damage following contusion-induced spinal cord injury in rats. J Neurosurg 2000;93(Suppl):85-93.
  11. Guest JD, Vanni S, Silbert L. Mild hypothermia, blood loss and complications in elective spinal surgery. Spine J 2004;4:130-137. https://doi.org/10.1016/j.spinee.2003.08.027
  12. Lenhardt R. Monitoring and thermal management. Best Pract Res Clin Anaesthesiol 2003;17:569-581. https://doi.org/10.1016/S1521-6896(03)00048-X