• Title/Summary/Keyword: Venous pressure

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Arterio-Venous Line Connection for Effective Intracardiac Deairing after Open Heart Surgery (개심술 후 저류공기의 효과적인 제거를 위한 동정맥도관의 설치)

  • 정성운;김종원;박준호
    • Journal of Chest Surgery
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    • v.36 no.11
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    • pp.834-838
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    • 2003
  • Background: Deairing from the heart after open heart surgery(cardiopulmonary bypass) is a very important procedure. Artificial arteriovenous fistula was used to remove air, and the efficiency was evaluated by transesophageal echocardiography. Material and Method: Just before termination of cardiopulmonary bypass, a standard pressure transducer line is connected between the stopcocks of the connections in the arterial and venous circuits, creating a small controlled arteriovenous fistula between the arterial and venous cannulas. The degree of intracardiac air and air removal time were evaluated either by transesophageal echocardiography or direct vision of pressure transducer line. Result: By simple procedure, cardiopulmonary time was shortened and air clearing can be confirmed using echocardiography in a few minutes. Conclusion: Creation of arteriovenous fistula using small connecting line between aortic and venous cannula is a very simple and effective method of deairing and preventing of air embolism after open heart surgery.

Cerebellar Hemorrhage due to a Direct Carotid-Cavernous Fistula after Surgery for Maxillary Cancer

  • Kamio, Yoshinobu;Hiramatsu, Hisaya;Kamiya, Mika;Yamashita, Shuhei;Namba, Hiroki
    • Journal of Korean Neurosurgical Society
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    • v.60 no.1
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    • pp.89-93
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    • 2017
  • Infratentorial cerebral hemorrhage due to a direct carotid-cavernous fistula (CCF) is very rare. To our knowledge, only four such cases have been reported. Cerebellar hemorrhage due to a direct CCF has not been reported. We describe a 63-year-old female who presented with reduced consciousness 3 days after undergoing a maxillectomy for maxillary cancer. Computed tomography showed a cerebellar hemorrhage. Magnetic resonance angiography showed a left-sided direct CCF draining into the left petrosal and cerebellar veins through the left superior petrosal sinus (SPS). Her previous surgery had sacrificed the pterygoid plexus and facial vein. Increased blood flow and reduced drainage could have led to increased venous pressure in infratentorial veins, including the petrosal and cerebellar veins. The cavernous sinus has several drainage routes, but the SPS is one of the most important routes for infratentorial venous drainage. Stenosis or absence of the posterior segment of the SPS can also result in increased pressure in the cerebellar and pontine veins. We emphasize that a direct CCF with cortical venous reflux should be precisely evaluated to determine the hemodynamic status and venous drainage from the cavernous sinus.

Effects of Backrest Position on Central Venous Pressure and Intracranial Pressure in Brain Surgery Patients (뇌수술환자에서 두부상승체위가 중심정맥압과 두개강내압에 미치는 영향)

  • Kim, Hyun-Ju;Sohng, Kyeong-Yae
    • Journal of Korean Academy of Nursing
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    • v.36 no.2
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    • pp.353-360
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    • 2006
  • Purpose: This study was done to investigate the effects of backrest elevation of 0 degree and 30 degrees that minimize the risk of increasing ICP when CVP is measured. Methods: Subjects were sixty-four patients who stayed in the neurosurgical intensive care unit after brain surgery at two university-based hospitals. CVP, blood pressure, heart rate and ICP were measured along with position changes in order of backrest position with primary 30 degrees backrest position, 0 degree backrest position and secondary 30 degrees backrest position. For data analysis, one-group, repeated-measures analysis of variance design was used in SAS program. Results: Backrest elevations from 0 degree to 30 degrees did not alter the CVP without increasing the ICP. Therefore, 30 degrees backrest position is a preventive position without increasing ICP. Conclusion: 30 degrees backrest position might be appropriate for brain injury patients when CVP is measured.

Accidental Vertebral Artery Cannulation as a Complication of the Central Venous Catherization (우발적인 척추동맥으로의 중심정맥 카테터의 삽관)

  • Jeong, Ju Ho
    • Journal of Trauma and Injury
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    • v.27 no.2
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    • pp.33-37
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    • 2014
  • Central venous catheterization through a subclavian approach is indicated for some special purposes but it may cause many complications such as infection, bleeding, pneumothorax, thrombosis, air embolization, arrhythmia, myocardial perforation, and nerve injury. A case involving a mistaken central venous catheterization into the right vertebral artery through the subclavian artery is presented. A 33-year-old man who had deteriorated mentality after head injury underwent an emergency craniotomy for acute epidural hematomas on the right frontal and temporal convexities. His mentality improved rapidly, but he complained of continuous severe pain in the right posterior neck even though he had no previous symptom or past medical history of such pain. Three-dimensional cervical spine computed tomography (3D-CT) was performed first to rule out unconfirmed cervical injuries and it revealed a linear radiopaque material intrathoracically from the level of the 1st rib up to the level of C6 in the right vertebral foramen. An additional neck CT was performed, and the subclavian catheter was indwelling in the right vertebral artery through right subclavian artery. For the purpose of proper fluid infusion and central venous pressure monitoring, the subclavian vein catheterization had been performed in the operation room after general anesthesia induction before the craniotomy. Sufficient anatomical consideration and prudence is essential because inadvertent arterial cannulation at a non-compressible site is a highly risky iatrogenic complication of central venous line placement.

Neuro-Behcet's Disease Presented with Cerebral Venous Sinus Thrombosis -A Case Report- (뇌정맥동혈전증으로 발현된 신경계베체트병 1예)

  • Lee, Yun-Kyung;Park, Mee-Young;Lee, Seung-Hyun;Joo, Sung-Gyun;Cho, Yong-Kook
    • Journal of Yeungnam Medical Science
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    • v.21 no.1
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    • pp.96-100
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    • 2004
  • Behcet's disease is a chronic, relapsing multisystem disorder, that may develop into variable neurological manifestations. They include vascular and parenchymal involvement. Vascular involvement is dominated by cerebral venous sinus thrombosis marked by benign intracranial hypertension. Cerebral venous sinus thrombosis can present with all the classical criteria for idiopathic intracranial hypertension, including normal brain CT findings with normal CSF content. But brain MRI is a useful diagnostic method in this situation to confirm the presence of cerebral venous sinus thrombosis. We experienced a case of raised intracranial pressure in a 21-year-old man, caused by cerebral venous sinus thrombosis. We disclosed his symptoms and signs thus fulfilling the diagnostic criteria for Behcet's disease.

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Massive hemothorax after central venous catheter insertion in a patient with multiple trauma

  • Park, Jeong Heon;Song, Jaegyok;Oh, Pyeong-wha
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.21 no.1
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    • pp.81-85
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    • 2021
  • Central venous catheter (CVC) insertion is commonly used in the operating room and intensive care unit to monitor central venous pressure and secure an intravenous route to deliver medications and nutritional support that cannot be safely infused into peripheral veins. However, CVC insertion may be associated with serious complications such as arterial puncture, hematoma, pneumothorax, hemothorax, catheter infections, and thrombosis. Several methods have been recommended to prevent these complications. Here we report a case of massive hemothorax caused by attempts of CVC insertion into the internal jugular vein and subclavian vein in a patient with multiple trauma. CVC placement should be performed or supervised by an experienced physician to decrease the incidence of CVC-related complications. CVC insertion under ultrasound guidance is recommended.

Effects of Two Kifferent Kinds of Socks on Physiologrical Responses (2종류의 양말착의행동이 인체생리반응에 미치는 효과)

  • 김희은;권오경
    • Journal of the Korean Society of Clothing and Textiles
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    • v.23 no.2
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    • pp.242-249
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    • 1999
  • The purpose of this study was to investigate two different kinds of socks on physiological responses at an ambient temperature of 35$\pm$1$^{\circ}C$ and relative humidity of 50$\pm$5% Five healthy women wearing normal socks or toes socks participated as the subjects. Rectal temperature skin temperatures sweat rate blood pressure pulse rate and questionnaire wee measured. Rectal temperature skin temperature sweat rate blood pressure pulse rate and questionnaire were measured. Rectal temperature and mean skin temperature were lower after exercise at wearing toes socks . Sweat rate was higher at wearing normal socks and blood pressure and pulse rate were tend to higher at wearing toes socks. Thermal comfort temperature sensation and humidity sensation were better wearing toes socks. Thermal comfort temperature sensation and humidity sensation were better wearing toes socks than wearing normal socks but wearing comfort was better at wearing normal socks. These results will be discussed form the viewpoint of thermoregulation AVA(Arterio venous Anastomosis) and count current heat exchange.

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Reconstruction of High-Pressure Paint Gun Injection Injured Finger Using Free Flaps with T-Shaped Pedicles and Multiple Venous Anastomoses

  • Lee, Jun Beom;Choi, Hwan Jun;Kim, Jun Hyuk;Cheon, Nam Ju;Lee, Young Man
    • Archives of Reconstructive Microsurgery
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    • v.24 no.2
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    • pp.75-78
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    • 2015
  • High-pressure (HP) injection injury to the upper extremity often causes a very serious clinical problem, leading to poor outcomes, including amputation, so that a true surgical emergency is required. The outcomes can be improved with emergent wide surgical debridement. However the diagnosis of these injuries is often delayed due to underestimated evaluation at first appearance and lack of common knowledge of the seriousness of this injury. The type and pressure of the infecting material is an important factor in prognosis and organic solvents infected pressure injury can cause poor outcome and increased amputation rate. In this case, we report on reconstruction of HP oil-based paint injection injuries of the finger using T-shaped pedicles and multiple venous anastomoses. In this concept, arterial flow can be maintained by the reverse flow of distal anastomosis when there is difficulty with the proximal anastomosis. And venous flow can be preserved by deep and superficial vein anastomosis. This concept has various advantages including preserving patency of the pedicle in chronic vasculopathy or trauma cases and maintaining the arterial flow by the reverse flow of distal anastomosis and can improve the free flap survival by a two vascular anastomosis system.

Low versus standard central venous pressure during laparoscopic liver resection: A systematic review, meta-analysis and trial sequential analysis

  • Mina Stephanos;Christopher M. B. Stewart;Ameen Mahmood;Christopher Brown;Shahin Hajibandeh;Shahab Hajibandeh;Thomas Satyadas
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.28 no.2
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    • pp.115-124
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    • 2024
  • To compare the outcomes of low central venous pressure (CVP) to standard CVP during laparoscopic liver resection. The study design was a systematic review following the PRISMA statement standards. The available literature was searched to identify all studies comparing low CVP with standard CVP in patients undergoing laparoscopic liver resection. The outcomes included intraoperative blood loss (primary outcome), need for blood transfusion, mean arterial pressure, operative time, Pringle time, and total complications. Random-effects modelling was applied for analyses. Type I and type II errors were assessed by trial sequential analysis (TSA). A total of 8 studies including 682 patients were included (low CVP group, 342; standard CVP group, 340). Low CVP reduced intraoperative blood loss during laparoscopic liver resection (mean difference [MD], -193.49 mL; 95% confidence interval [CI], -339.86 to -47.12; p = 0.01). However, low CVP did not have any effect on blood transfusion requirement (odds ratio [OR], 0.54; 95% CI, 0.28-1.03; p = 0.06), mean arterial pressure (MD, -1.55 mm Hg; 95% CI, -3.85-0.75; p = 0.19), Pringle time (MD, -0.99 minutes; 95% CI, -5.82-3.84; p = 0.69), operative time (MD, -16.38 minutes; 95% CI, -36.68-3.39; p = 0.11), or total complications (OR, 1.92; 95% CI, 0.97-3.80; p = 0.06). TSA suggested that the meta-analysis for the primary outcome was not subject to type I or II errors. Low CVP may reduce intraoperative blood loss during laparoscopic liver resection (moderate certainty); however, this may not translate into shorter operative time, shorter Pringle time, or less need for blood transfusion. Randomized controlled trials with larger sample sizes will provide more robust evidence.