学術雑誌論文 Massive subcutaneous emphysema, bilateral pneumothorax, pneumomediastinum, pneumoperitoneum, pneumoretroperitoneum, and pneumoscrotum after multiple direct laryngoscopies: an autopsy case report

Ono, Yuko  ,  Okubo, Yoshinori  ,  Hashimoto, Katsuhiko  ,  Inokuchi, Ryota  ,  Odajima, Hajime  ,  Tase, Choichiro  ,  Shinohara, Kazuaki

29 ( 4 )  , pp.622 - 626 , 2015-08 , Springer
ISSN:0913-86681438-8359
NII書誌ID(NCID):AA10852931
内容記述
Multiple endotracheal intubation (ETI) attempts increase the risk of airway-related adverse events. However, little is known about autopsy findings after severe ETI-related complications. We present the detailed pathological findings of a case with severe ETI-related complications. A 77-year-old obese male suffered cardiopulmonary arrest after choking at a rehabilitation facility. Spontaneous circulation returned after chest compressions and foreign-body removal. After multiple failed direct laryngoscopies, the patient was transferred to our hospital. He had massive subcutaneous emphysema, bilateral pneumothorax, pneumomediastinum, pneumoperitoneum, pneumoretroperitoneum, and pneumoscrotum on admission and died from hypoxic brain injury 15 hours later. Autopsy revealed severe oropharyngeal; laryngeal; and left lung lower lobe injury. The likely mechanisms of diffuse emphysema were: 1) oropharyngeal injury associated with multiple ETI attempts and excessive ventilation pressures and 2) left lung lower lobe injury associated with chest compressions and other resuscitative procedures. Multiple laryngoscopies can cause severe upper-airway injury, worsen respiratory status, and make ETI more difficult—a vicious circle that can be prevented by limiting ETI attempts. This is particularly important in unfavorable environments, in which backup devices and personnel are not easily obtained. The pathological findings of our patient caution against repeated attempts at ETI during resuscitation.
本文を読む

http://ir.fmu.ac.jp/dspace/bitstream/123456789/524/1/JAnesth_29_p622.pdf

このアイテムのアクセス数:  回

その他の情報