• Title/Summary/Keyword: Central venous

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Retrograde Cerebral Perfusion in the Surgical Treatment of Ascending Aortic Aneurysm -Report of 4 Cases- (역행성 뇌혈 관류를 이용한 상행대동맥류 수술 -4례 보고-)

  • 문승호
    • Journal of Chest Surgery
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    • v.28 no.8
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    • pp.788-791
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    • 1995
  • Dissecting aortic aneurysm of ascending aorta is a life threatening condition which requires prompt surgical correction. With deep hypothermic circulatory arrest and retrograde cerebral perfusion via superior vena cava, we could replaced ascending aorta in 4 cases safely. All of 4 cases; femoral artery, right auricle were used as cannulation site. The duration of circulatory arrest were 28, 30, 45, 60 minute in each cases and rectal temperature was 2$0^{\circ}C$ at that time. At the time of retrograde cerebral perfusion, we maintained central venous pressure under 25mmHg. We resected all of dissecting portion and replaced it with Hemashield graft. There were no deaths but two of four reoperated because of bleeding.

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Pericardiectomy in Constrictive Pericarditis -23 Cases- (만성 교약성 심낭염의 외과적 치료)

  • 하현철
    • Journal of Chest Surgery
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    • v.28 no.2
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    • pp.143-149
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    • 1995
  • From January, 1983, to August, 1993, 23 cases of pericardiectomy for chronic constrictive pericarditis were carried out. The 15 male and 8 female patients ranged in age from 7 to 68 years[mean 39.1 years . All patients underwent pericardiectomy through a median sternotomy. Postoperative complications were low cardiac output[2 patients , wound infection[2 patients , pneumonia[2 patients , and unilateral phrenic nerve palsy[2 patients . One patient died of low cardiac output 1 day after pericardiectomy due to the associated transposition of great artery and hypoplastic right lung. Clinical and pathological findings showed that the cause of constrictive pericarditis was tuberculous in 8 cases[34.8% , idiopathic in 12 cases[52.2% and pyogenic in 3 cases[13.0% . Central venous pressure fell below 10cmH2O by immediate in 6 cases, fell below 10cmH2O by 24hrs in 5 cases and continued above 10cmH2O after 24hrs in 12 cases. Preoperative NYHA functional class of patients showed class I-1, classII-4, class III-14, and class IV-3. Postoperativly NYHA functional class was improved to class I-15, classII-6, class III-1.

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Venous Varix of the Digit - Two Cases Report - (수지에 발생한 정맥류 - 2예 보고 -)

  • Lee, Jin-Seok;Jung, Young-Jin;Sohn, Hyung-Bin;Hong, In-Pyo
    • Archives of Reconstructive Microsurgery
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    • v.17 no.1
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    • pp.55-59
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    • 2008
  • Varix of the digit is generally defined as an enlarged, tortuous palmar digital vein with or without thrombus within it. It usually presents as a firm, blue mass on the volar aspect of the finger. Mechanical compression or chronic trauma to veins on the volar surface of a digit appears central to the pathogenesis of this lesion. Aging phlebectasia has also been considered as a cause of this lesion in the elderly. A tourniquet test may be useful in demonstrating the presence of a digital varix, but it is confirmed by postoperative microscopic examination. Excision of a symptomatic lesion has proven to be curative. We report two cases of symptomatic digital varix which developed in the fourth finger with a review of literatures.

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Giant Arachnoid Granulation Misdiagnosed as Transverse Sinus Thrombosis

  • Choi, Hyuk-Jin;Cho, Chang-Won;Kim, Yoon-Suk;Cha, Jae-Hun
    • Journal of Korean Neurosurgical Society
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    • v.43 no.1
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    • pp.48-50
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    • 2008
  • We experienced a case of giant arachnoid granulation misdiagnosed as dural sinus thrombosis. A 66-year-old woman presented with a one month history of progressive occipital headache. Computed tomography angiography and cerebral angiography showed a round filling defect at the transverse sinus which was speculated as a transverse sinus thrombosis. Anticoagulation therapy was performed to prevent worsening of thrombosis for 2 weeks and then a Gadolinium-enhanced magnetic resonance imaging scan was performed. The filling defect lesion at the transverse sinus revealed a non-enhancing granule with central linear enhancement, which was compatible with giant arachnoid granulation. We checked the intrasinus pressure difference across the lesion the through the dural sinus in order to exclude the lesion as the cause of headache. Normal venous pressure with no significant differential pressure across the lesion was noted. Headache was treated with medical therapy.

Study on Clinical Utility of the Laryngeal Mask Airway in Dogs (개에서 Laryngeal Mask Airway의 임상적 효용성에 관한 연구)

  • Kim Yong-hoon;Lee Joo-myoung;Cheong Jongtae
    • Journal of Veterinary Clinics
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    • v.22 no.3
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    • pp.214-219
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    • 2005
  • This experiment was conducted in order to identify the effect of the laryngeal mask airway and it's clinical utility on cardiovascular system, intraocular pressure and stress reaction at the time of anesthesia care. The heart rate, systolic arterial pressure, diastolic arterial pressure and intraocular pressure were significantly reduced in the experimental group to be compared with the control group. But, there were no significant differences in mean arterial pressure, central venous pressure and blood cortisol concentration between both groups. In view of the above results, it is thought that the airway management using the laryngeal mask airway will be useful to reduce the stress condition in the induction of anesthesia.

Surgical Treatment of A-V Fistula Following Lumber Laminectomy (요추 추굴절제술후에 발생한 동정맥루의 외과적 치료 -증례보고-)

  • 장택희
    • Journal of Chest Surgery
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    • v.27 no.5
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    • pp.399-401
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    • 1994
  • We experienced one case of surgical treatment of A-V fistula between the right common iliac artery and the right common iliac vein after lumbar laminectomy. The average vascular surgeon does not have extensive experience with this disorder owing to its rarity. Arteriovenous fistula of the aorta and its major branches present an unparalleled challenge in patient care. Because of their central location, blood flow through these fistulas may be massive;the associated complications are usually dramatic, resulting in severe refractory congestive heart failure, massive venous hypertension, or extensive hemorrhage during an illfated surgical repair.For this reason, it behooves one to become well acquainted with the problem in order to avoid morbid complications and thus ensure optimal patient care.

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Cerebral Air Embolism: a Case Report with an Emphasis of its Pathophysiology and MRI Findings

  • Kang, Se Ri;Choi, See Sung;Jeon, Se Jeong
    • Investigative Magnetic Resonance Imaging
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    • v.23 no.1
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    • pp.70-74
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    • 2019
  • Cerebral air embolism (CAE) is a rare complication of various medical procedures. It manifests with symptoms similar to those of typical acute cerebral infarction, however the treatment is quite different. We present a case of arterial CAE that was associated with a disconnected central venous catheter and appeared as punctate dark signal intensities with aliasing artifacts on the susceptibility-weighted filtered phase magnetic resonance image. The susceptibility-weighted filtered phase image can be helpful for diagnosing CAE and the magnetic resonance imaging reflects the pathophysiology of CAE.

Successful Treatment of Catheter Related Blood Stream Infection By Millerozyma farinosa with Micafungin: A Case Report

  • Hong, Sun In;Suh, Young Sun;Kim, Hyun-Ok;Bae, In-Gyu;Shin, Jong Hee;Cho, Oh-Hyun
    • Infection and chemotherapy
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    • v.50 no.4
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    • pp.362-366
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    • 2018
  • Millerozyma farinosa (formerly Pichia farinosa) is halotolerant yeast mainly found in food and ubiquitous in the environment. It was a rare yeast pathogen, but it has recently emerged as a cause of fungemia in immunocompromised patients. Optimal therapy for invasive fungal infection by this pathogen remains unclear. We report a case of catheter related blood stream infection caused by M. farinosa in a 71-year-old patient who recovered successfully after removal of the central venous catheter and treatment with micafungin.

Nurses' Knowledge and Performance for the Prevention of Intravascular Catheter-related Infections according to the Strength of Recommendations of Evidence based Guidelines (정맥관 감염예방 근거중심 가이드라인의 권고강도 별 간호사의 지식 및 수행정도)

  • Ryu, Se-Ang;Kim, Yun-Hee;Jang, Keum-Seong;Chung, Kyung-Hee;Choi, Ja-Yun;Yang, Jin-Ju;Park, Soon-Joo
    • Korean Journal of Adult Nursing
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    • v.24 no.5
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    • pp.546-555
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    • 2012
  • Purpose: The objective of this study was to examine the relationships between nurses' knowledge and performance for the prevention of intravascular catheter-related infections (ICRI) according to the strength of recommendations in evidence based guidelines (EBG). Methods: The total participants were 144 nurses working for medical surgical unit and intensive care unit. Data were collected from July 12 to July 30, 2010 and analyzed by one way ANOVA and Pearson's correlation analysis. Results: The knowledge and performance mean scores were $0.80{\pm}0.17$ and $3.04{\pm}0.31$ for peripheral venous catheter (PVC) management, and $0.83{\pm}0.17$ and $3.00{\pm}0.30$ for central venous catheter (CVC) management respectively. The items of category IA had the highest knowledge score (F=44.70, p<.001) and the items of category II had the highest performance score (F=47.09, p<.001) in PVC management, while the items of category IA had the highest knowledge (F=20.04, p<.001) and performance scores (F=18.20, p<.001) in CVC management. Knowledge and performance scores were significantly correlated in CVC management (r=.24, p=.004), but not in PVC management (r=.03, p=.753). Conclusion: EBG for the prevention of ICRI was not fully implemented in clinical settings. These findings emphasize that clinical professions need to develope strategies to enhance nursing practices with evidence based guideline.

Analysis of Complication in Pediatric Patients with Hickman Catheters (히크만 카테터를 삽입한 소아 환자에서 발생한 합병증 분석)

  • Kim, Tae-Hoon;Kim, Dae-Yeon;Cho, Min-Jeong;Kim, Seong-Chul;Kim, In-Koo
    • Advances in pediatric surgery
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    • v.16 no.1
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    • pp.25-31
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    • 2010
  • Hickman catheters are tunneled central venous catheters used for long-term venous access in children with malignancies. The appropriate management for various kinds of catheter related complications has become a major issue. We retrospectively analyzed the clinical, demographic, and surgical characteristics in 154 pediatric hemato-oncology patients who underwent Hickman catheter insertion between January 2005 and December 2009. There were 92 boys and 62 girls. The mean age at surgery was $7.6{\pm}5.1$ years old. The mean operation time was $67.4{\pm}21.3$ minutes and C-arm fluoroscopy was used in 47(30.5 %). The causes of Hickman catheter removal were termination of use in 82 (57.3 %), catheter related bloodstream infection in 44(30.8 %), mechanical malfunction in 11(7.7 %), and accidents in 6(4.2 %). Univariate and multivariate analysis for associated factors with catheter related bloodstream infection showed that there were no statistically significant associated factors with catheter related infection complications. All cases except two showed clinical improvement with catheter removal and relevant antibiotics treatment. The mean catheter maintenance period in patients of catheter removal without complications was $214.9{\pm}140.2$ days. And, The mean catheter maintenance period in patients of late catheter related bloodstream infection was $198.0{\pm}116.0$ days. These data suggest that it is important to remove Hickman catheter as soon as possible after the termination of use. When symptoms and signs of complications were noticed, prompt diagnostic approach and management can lead to clinical improvements.

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