• Title/Summary/Keyword: Hypothermia

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Clinical Experience of Open Heart Surgery under Extracorporeal Circulation -Review of Operation 131 Cases- (개심술에 의한 심질환의 외과적 치료 -131 례 수술경험-)

  • 유회성
    • Journal of Chest Surgery
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    • v.13 no.4
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    • pp.394-404
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    • 1980
  • During the period of June 1976 October 1980 131 cases of Open heart Surgery was performed at the National Medical Center in Seoul under the extracorpocal circulation. 77 cases were congenital heart disease and 54 were acquired heart disease. The age of the patients ranged between 2$\frac{1}{2}$ and 51 years. For all patients partial hemodilution technique and moderte hypothermia was used during extracorporeal circulation and cardioplegia was done for myocardial protection since April 1978. 41 of congenital cases were non-cyanotic group and 1 case died. 36 of congenital cases were cyanotic group and revealed very high mortiality rate (16 death, 39%). 53 of acquired cases were cases of valvular heart disease, 34 mitral (3 death), 1 aortic, 4 mitral with aortic 12 mitral with tricuspid (3 death), 2 triple valves (2 death), and revealed mortality rate of 15.1% (8 death). 1 of acquired cases were left atrial myxoma. There were 25 cases of operative death and over all motality rate was 19.1%.

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Surgical correction of TAPVR of cardiac type in small infant - 1 Case - (유아의 총폐정맥 이상환류증 치험 1례)

  • 이성윤
    • Journal of Chest Surgery
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    • v.24 no.9
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    • pp.930-944
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    • 1991
  • Infants born with TAPVR have a generally unfavorable prognosis, only a bout 20% surviving first year of life. In fact only about 50% survive beyond the age of 3 months, death occurring in the first few weeks or months of life. In 1991, we experienced 1 case of TAPVR of cardiac type in infant[2 months old age, W; 3.4kg] Repair was performed under the deep hypothermia with CPB, and continuous low-perfusion technique. The septum between enlarged coronary sinus opening and left atrium was carefully excised. A patch of pericardium was then sutured around the coronary sinus and ASD, so that the blood from the pulmonary veins and the coronary sinus was diverted in the left atrium. The postoperative course was uneventful except pneumothorax. The patient has been doing well on 6 months follow-up.

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Massive Rhabdomyolysis Following Cardiopulmonary Bypass

  • Kim, Young Sam;Yoon, Yong Han;Kim, Joung Taek;Baek, Wan Ki
    • Journal of Chest Surgery
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    • v.47 no.2
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    • pp.181-184
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    • 2014
  • Here, we report a case of massive rhabdomyolysis following an uncomplicated repair of a ventricular septal defect in a five-month-old baby. Postoperatively, the patient was hemodynamically stable but metabolic acidosis continued, accompanied by fever and delayed mental recovery. The next day, he became comatose and never regained consciousness thereafter. The computed tomography of the brain revealed a diffuse brain injury. The patient followed a downhill course and eventually died on postoperative day 33. An unusually high level of creatine phosphokinase was noticed, peaking (21,880 IU/L) on postoperative day 2, suggesting severe rhabdomyolysis. The relevant literature was reviewed, and the possibility of malignant hyperthermia obscured by cardiopulmonary bypass and hypothermia was addressed.

Normothermic Cardiac Surgery with Warm Blood Cardioplegia in Patient with Cold Agglutinins

  • Cho, Sang-Ho;Kim, Dae Hyun;Kwak, Young Tae
    • Journal of Chest Surgery
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    • v.47 no.2
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    • pp.133-136
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    • 2014
  • Cold agglutinins are predominately immunoglobulin M autoantibodies that react at cold temperatures with surface antigens on the red blood cell. This can lead to hemagglutination at low temperatures, followed by complement fixation and subsequent hemolysis on rewarming. Development of hemagglutination or hemolysis in patients with cold agglutinins is a risk of cardiac surgery under hypothermia. In addition, there is the potential for intracoronary hemagglutination with inadequate distribution of cardioplegic solutions, thrombosis, embolism, ischemia, or infarction. We report a patient with incidentally detected cold agglutinin who underwent normothermic cardiac surgery with warm blood cardioplegia.

A Case of Amitraz Insecticide Intoxication after Ingestion of Large Amount (많은 양을 음독한 급성 amitraz 살충제 중독 1례)

  • Suh, Joo-Hyun;Roh, Hyung-Keun
    • Journal of The Korean Society of Clinical Toxicology
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    • v.6 no.1
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    • pp.52-56
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    • 2008
  • Amitraz is used as farm-animal insecticide. Its side effects in humans are related to its pharmacological activity on alpha 2-adrenergic receptors. The case describes a previously healthy 46-year-old woman who intentionally ingested approximately 250mL of liquid amitraz. She presented with vomiting, altered mental status, miosis, dry mouth, hypopnea, metabolic and respiratory acidosis, hypotension, hypothermia, polyuria, metabolic acidosis, elevated serum aminotransferase and abdominal distension. Supportive treatments including mechanical ventilation, hydration, dopamine infusion, bicarbonate infusion and gastric decompression resulted in improvement. By hospital day 3, she recovered with resolution of abdominal distension. It is paramount to recognize amitraz poisoning when a pesticide-intoxicated patient presets with signs and symptoms consistent with organophosphate intoxicated patients but with greater alpha 2-adrenergic related symptoms such as decreased bowel motility and xerostomia.

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Diagnostic imaging and treatment of hepatic abscess in a Dachshund (개에서 발생한 간 농양의 진단 영상과 치료 증례)

  • Jung, Joohyun;Chae, Woongjoo;Chang, Jinhwa;Oh, Sunkyoung;Yoon, Junghee;Choi, Mincheol
    • Korean Journal of Veterinary Research
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    • v.48 no.1
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    • pp.119-124
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    • 2008
  • A castrated male, 4-year old, Dachshund weighing 5.3 kg with an acute history of anorexia, vomiting, severe depression, and hypothermia for 1 day was referred. Severe leukopenia, mild increased hepatic enzymes, and mild imbalanced electrolyte were found on laboratory tests. There are no remarkable findings on abdominal radiographs. Ultrasonography showed multifocal heterogeneous and hypoechoic round regions in the liver. Ultrasound guided fine needle aspiration and drainage were performed and hepatic abscess was diagnosed. The patient was recovered normally without any complications through aggressive medical treatments from the result of culture and sensitivity test.

Hemodilution in Clinical Extracorporeal Circulation (체외순환을 위한 혈액희석법에 대하여)

  • 이성행
    • Journal of Chest Surgery
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    • v.10 no.2
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    • pp.250-267
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    • 1977
  • Open heart surgery has been performed on 20 patients, using hemodilution principle under the moderate hypothermia from Dec. 1975 through Aug. 1977 at the Department of Thoracic and Cardiovascular Surgery, Kyungpook National University School of Medicine. All these patients, body surface area ranged from 0.53 to 1.67$M^2$, were divided into two groups as a child group [below 15 yrs] and a adult group[above 15 yrs]. The oxygenator were primed with fresh ACD blood, 5 per cent dextrose, Hartmann`s solution, 15 per cent mannitol, sodium bicarbonate, dexamethasone and antibiotics. The average flow rate was 2.0 L/$M^2$/min. in child group and 2.3L/$M^2$/min. in adult group. The degree of hemodilution in child and adult group was 30.7% and 29.3% respectively. The minimal value of rectal temperature was $30.84{\pm}0.7^{\circ}C.$, in child group and $30.0{\pm}1.5^{\circ}C.$, in adult group. We studied the changes of hemodynamic status, blood components, electrolyte, acid-base status. blood lactic acid and urine output during and after cardiopulmonary bypass.

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Congenital Fistula of the Right Coronary Artery to the Left Ventricle; A Case Report (우관동맥과 좌심실사이의 선천성 동맥루;1례 보고)

  • 홍은표
    • Journal of Chest Surgery
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    • v.26 no.9
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    • pp.710-713
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    • 1993
  • Congenital coronary fistula is a rare condition, and with widespread use of cardiac catheterization, angiography and selective coronary arteriography are being recognized with increasing frequency. Fistula originating from the right coronary artery are more common than those from the left coronary artery. The fistula empties into the right side of the heart in 90% of the cases with the right ventricle being the most common recipient chamber, followed by the right atrium and the pulmonary artery. We report a case of congenital coronary artery fistula of the right coronary artery to the left ventricle with significant shunt in a 20 - year old female. It was detected by transthoracic and transesophageal echocardiography and confirmed by cardiac catheterization and coronary angiography. The fistula opening was closed with 6-0 Prolene continuously under cardiopulmonary bypass and moderate hypothermia [ 28 oC ]. Postoperative course was uneventful and the patient was discharged without specific problem.

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Dimethoate Intoxication with Refractory Shock and Hyperglycemia (치료에 불응하는 지속적 저혈압과 고혈당 상태를 보인 dimethoate 중독 1례)

  • Kim, Jae-Eun;Jung, Jin-Hee;Bae, Hyun-A;Eo, Eun-Kyung
    • Journal of The Korean Society of Clinical Toxicology
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    • v.5 no.1
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    • pp.46-49
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    • 2007
  • Organophosphorus insecticides induce different clinical manifestations varying according to the different side groups attached to the phosphate, their rates of degradation, and their fat solubilities. In consequence of this variation, specific treatments are required for particular organophosphorus insecticides. We report a unusual case of intoxication with dimethyl organophosphorus insecticide in a 26-year-old woman. She manifested atypical and ultimately fatal symptoms including profound shock, refractory hyperglycemia, and hypothermia.

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Corrective surgery for congenital heart disease under 10 kg of body weight (체중 10 kg 이하의 선천성 심장병환자에 대한 교정수술)

  • Jin, Seong-Hun;Seo, Gyeong-Pil
    • Journal of Chest Surgery
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    • v.18 no.1
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    • pp.24-35
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    • 1985
  • Between January 1980 and July 1984, 321 cases of open heart surgery for infants or small children under 10Kg of body weight were performed, which occupied the great part of total open heart surgery done in the same period. The mean age was 16.58.7 months [ranging from 2 days to 51 months], and the mean body weight was 7.8a1.8Kg [from 2.8 to 10Kg] which was below the third percentile compared with the mean age. The technique of deep hypothermia with total circulatory arrest, which contributed to great improvement in operative condition, was used increasingly and widespreadly in this period. For each anomaly, the number of patients and operative deaths were as follows: VSD, 11 of 184 [6.0%]; TOF, 8 of 47 [17.8%]; TGA, 13 of 30 [43.3%]; ASD, none of 9; TAPVR, 1 of 8 [12.7%]; C-ECD, 3 of 6 [50%]; Tricuspid Atresia, 4 of 5 [80%]; Pulmonary Atresia, 2 of 4 [50%]; Congenital Mitral Anomaly, 1 of 3 [33.3%]; P-ECD, none of 3

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