JA Clinical Reports最新文献

{"title":"Pitfalls of continuous drug administration methods in pediatric anesthesia to reduce medication errors.","authors":"Keisuke Yoshida, Yuko Nakano, Satoki Inoue","doi":"10.1186/s40981-023-00685-x","DOIUrl":"10.1186/s40981-023-00685-x","url":null,"abstract":"","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10730475/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138800031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Suspected anaphylaxis during anesthesia induction without identified allergens: a case report","authors":"Sayaka Hirai, Mitsuru Ida, Ai Arima, Masahiko Kawaguchi","doi":"10.1186/s40981-023-00684-y","DOIUrl":"https://doi.org/10.1186/s40981-023-00684-y","url":null,"abstract":"<p>To the Editor,</p><p>The Japanese Society of Anesthesiologists offers practical guidelines for dealing with perioperative anaphylaxis, emphasizing the importance of anesthesiologists’ involvement in identifying the causative agent to prevent recurrence [1]. However, identifying the causative agents is not always feasible. Herein, we report, with written informed consent, a case where anaphylaxis was suspected during anesthesia induction, yet no allergens were identified.</p><p>A 59-year-old man, 165.5 cm in height and weighing 65.1 kg, presented with congestive heart failure, chronic kidney disease, diabetes, hypertension, and hyperlipidemia, requiring coronary artery bypass grafting for triple-vessel coronary artery disease. The patient had not undergone any surgery previously and had not taken any angiotensin receptor blockers and angiotensin-converting enzyme inhibitors. In the operating room, standard vital signs were closely monitored, and non-invasive blood pressure (NIBP) was recorded at 160/120 mmHg. Anesthesia was induced using remifentanil (rate, 20 mL/h) and remimazolam (12 mg/kg/h). Upon confirming the loss of consciousness, the dosages of remifentanil and remimazolam were reduced to 5 mL/h and 1.0 mg/kg/h, respectively, four minutes after administering rocuronium (60 mg). This was followed by tracheal intubation and arterial catheter insertion. His blood pressure (BP) was 89/67 mm Hg (NIBP) and 47/25 mm Hg (arterial line) immediately before and after tracheal intubation, respectively. Despite fluid resuscitation of 500 mL and multiple boluses of ephedrine (16 mg), phenylephrine (0.3 mg), and norepinephrine (10 µg), he experienced cardiac arrest. During chest compressions, an intravenous bolus of epinephrine (0.1 mg) was administered, resulting in cardiopulmonary resuscitation with an arterial BP of 46/29 mmHg. However, due to persistent severe hypotension, continuous infusions of norepinephrine at 0.1 mcg/kg/min and dobutamine at 5 mcg/kg/min were initiated following additional boluses of epinephrine (0.3 mg). Figure 1 displays the patient’s vital signs during anesthesia. Edema with erythema of the extremities and trunk was observed throughout this sequence, and transesophageal echocardiography revealed no evidence of cardiogenic shock. Consequently, anaphylaxis was suspected, and the patient was transferred to the intensive care unit without proceeding with surgery. Blood samples taken before he left the operating room indicated an elevated serum tryptase level of 17.1 μg/L, exceeding the normal range of 1.2–5.7 μg/L. More than seven weeks after the onset, both basophil activation and skin prick tests using remimazolam and rocuronium yielded negative results. The patient declined surgery and was subsequently followed-up after percutaneous coronary intervention at coronary segments 6, 7, 11, and 14.</p><figure><figcaption><b data-test=\"figure-caption-text\">Fig. 1</b></figcaption><picture><img alt=\"figure 1\" aria-describedby=\"Fig1\"","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138714628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"General anesthesia for cesarean section in a pregnant woman with systemic vascular malformation: a case report","authors":"Noriko Takeuchi, Misa Koshihara, Akira Motoyasu, Joho Tokumine, Harumasa Nakazawa, Mine Ozaki, Tomoko Yorozu","doi":"10.1186/s40981-023-00682-0","DOIUrl":"https://doi.org/10.1186/s40981-023-00682-0","url":null,"abstract":"Vascular malformations are composed of morphologically abnormal vascular tissue, and when located in the head and neck region, they can make it difficult to secure the airway during general anesthesia. A 28-year-old pregnant woman with vascular malformations in the pharynx was scheduled to undergo a cesarean section, for which spinal anesthesia was initially chosen. However, after magnetic resonance imaging results revealed the presence of multiple vascular malformations in the lumbar multifidus muscles, spinal anesthesia was considered to be of high risk. Thus, the patient was subjected to general anesthesia tracheal intubation under sedation, and the course of the surgery was without complications. Because the pathophysiology and clinical sequelae of vascular malformations may be involved in complications, thorough presurgical evaluation of the patient’s physical condition and careful anesthesia planning should be done.","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138631378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Family reunion activity may be used as an alternative item for sexual activity in the Duke Activity Status Index.","authors":"Satoki Inoue","doi":"10.1186/s40981-023-00680-2","DOIUrl":"10.1186/s40981-023-00680-2","url":null,"abstract":"","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10700227/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138498403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aortic valve replacement in a 41-year-old woman with uncorrected tetralogy of Fallot, pulmonary atresia, and major aortopulmonary collateral arteries: a case report.","authors":"Kazutomo Saito, Yudai Iwasaki, Takahiro Tasaki, Hidehisa Saito, Hiroaki Toyama, Yutaka Ejima, Masanori Yamauchi","doi":"10.1186/s40981-023-00674-0","DOIUrl":"10.1186/s40981-023-00674-0","url":null,"abstract":"<p><strong>Background: </strong>Tetralogy of Fallot (TOF) is a complex cyanotic congenital heart disease. As most patients with TOF undergo palliative or radical surgical repair during childhood, cardiac surgery under cardiopulmonary bypass (CPB) for adult survivors with unrepaired TOF is exceedingly rare.</p><p><strong>Case presentation: </strong>A 41-year-old woman with unrepaired TOF, pulmonary atresia (PA), and major aortopulmonary collateral arteries (MAPCAs) developed acute infectious endocarditis (IE). As vegetation gradually increased despite intravenous antibiotic administration, she was scheduled for urgent aortic valve replacement under CPB. Pulmonary blood flow was primarily provided by the MAPCAs originating from the descending aorta. Intra-aortic balloon occlusion for MAPCAs was performed to ensure a bloodless surgical field. Aortic valve replacement was successful.</p><p><strong>Conclusion: </strong>An adult with uncorrected TOF developed acute IE and subsequently had successful cardiac surgery under CPB. Understanding TOF physiology with PA and MAPCAs, particularly pulmonary blood flow through MAPCAs, is crucial.</p>","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10700252/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138487494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive underestimation of difficult direct laryngoscopy in a patient with rheumatoid arthritis-associated immobilized craniocervical junction.","authors":"Hirotaka Matsuyama, Masato Hara, Atsushi Seto, Teruyuki Hiraki","doi":"10.1186/s40981-023-00679-9","DOIUrl":"10.1186/s40981-023-00679-9","url":null,"abstract":"<p><strong>Background: </strong>The upper cervical spine is a major focus of damage by rheumatoid arthritis (RA). Specific screening for mobility of the upper cervical spine, which is essential for direct laryngoscopy, is lacking. Herein, we present a case of RA with Cormack-Lehane grade IV, which was not predicted by preoperative examination.</p><p><strong>Case presentation: </strong>A 66-year-old woman with RA was scheduled for a right total knee arthroplasty and right elbow synovectomy. She had a long history of RA without symptoms related to the cervical spine or spinal cord. Although physical examination suggested moderate risk of difficult intubation with preserved cervical retroflexion, her Cormack-Lehane classification was grade IV under muscle relaxation. Bony integration of the occiput to axis was considered to be the main cause of difficult direct laryngoscopy, and restricted neck rotation was found postoperatively.</p><p><strong>Conclusions: </strong>RA patients may have limited upper cervical spine motion despite normal cervical retroflexion.</p>","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10697918/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138487495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unexpected abnormal positive pressure due to misconnection of excess gas tube.","authors":"Atsuhiro Kitaura, Hiroatsu Sakamoto, Kensuke Toho, Shota Tsukimoto, Haruyuki Yuasa, Yasufumi Nakajima","doi":"10.1186/s40981-023-00677-x","DOIUrl":"10.1186/s40981-023-00677-x","url":null,"abstract":"","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10689322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138459996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac tamponade developing during Trousseau's syndrome with pulmonary embolism.","authors":"Yuya Itakura, Takahiro Hakozaki, Satoki Inoue","doi":"10.1186/s40981-023-00678-w","DOIUrl":"10.1186/s40981-023-00678-w","url":null,"abstract":"","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10689664/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138459995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between delirium and grip strength in ICU patients for cardiac surgery (D-GRIP study).","authors":"Taichi Kotani, Satoki Inoue, Mitsuru Ida, Yusuke Naito, Masahiko Kawawguchi","doi":"10.1186/s40981-023-00676-y","DOIUrl":"10.1186/s40981-023-00676-y","url":null,"abstract":"","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10673756/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138434041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Severe pressure ulcer caused by an electrode belt for monitoring electrical impedance tomography in two patients in the prone position.","authors":"Takayuki Hasegawa, Keisuke Yoshida, Takahiro Hakozaki, Satoki Inoue","doi":"10.1186/s40981-023-00675-z","DOIUrl":"10.1186/s40981-023-00675-z","url":null,"abstract":"","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10673774/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138434042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}