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福島県立医科大学学術成果リポジトリ = Fukushima Medical University Repository >
A 医学部 = School of Medicine >
a10 学術雑誌論文等 = Journal Article >
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http://ir.fmu.ac.jp/dspace/handle/123456789/524
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| タイトル: | Massive subcutaneous emphysema, bilateral pneumothorax, pneumomediastinum, pneumoperitoneum, pneumoretroperitoneum, and pneumoscrotum after multiple direct laryngoscopies: an autopsy case report |
| 著者: | Ono, Yuko
Okubo, Yoshinori
Hashimoto, Katsuhiko
Inokuchi, Ryota
Odajima, Hajime
Tase, Choichiro
Shinohara, Kazuaki |
| 学内所属: | 救急医療学講座 |
| 誌名/書名: | Journal of anesthesia |
| 巻: | 29 |
| 号: | 4 |
| 開始ページ: | 622 |
| 終了ページ: | 626 |
| 発行日: | 2015年8月 |
| 抄録: | 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. |
| 出版者: | Springer |
| 本文の言語: | eng |
| このページのURI: | http://ir.fmu.ac.jp/dspace/handle/123456789/524 |
| 本文URL: | http://ir.fmu.ac.jp/dspace/bitstream/123456789/524/1/JAnesth_29_p622.pdf |
| ISSN: | 0913-8668
1438-8359 |
| DOI: | 10.1007/s00540-015-1997-9 |
| PubMed番号: | 25784502 |
| 異版(出版者版等): | http://dx.doi.org/10.1007/s00540-015-1997-9 |
| 権利情報: | © Japanese Society of Anesthesiologists 2015. The final publication is available at link.springer.com. |
| 出現コレクション: | a10 学術雑誌論文等 = Journal Article
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