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인공 슬관절 전치환술 중 경식도 초음파 감시하의 색전 출현: 혈역학적 변화와 색전의 구성

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Author(s)
김진모박정희이주영Jin Mo KimJung Hee ParkJoo Yeung Rhee
Keimyung Author(s)
Kim, Jin Mo
Department
Dept. of Anesthesiology & Pain Medicine (마취통증의학)
Journal Title
대한마취과학회지
Issued Date
1998
Volume
34
Issue
6
Abstract
Background: The present study was aimed to determine the alterations of hemodynamics and embolic composition during the course of total knee replacement.
Methods: A retrospective analysis was performed using data acquired from 20 patients who underwent 10 unilateral and 10 bilateral total knee replacement under general anesthesia. Transesophageal echocardiography and Swan-Ganze catheterization were placed following induction of anesthesia, then images and changes were recorded throughout the procedure. All patients were performed using fluted intramedullary rods inserted into an overdrilled femoral entrance hole in conjunction with the application of a tourniquet.
Results: We found echogenic emboli in 8 out of 20 patients during cannulation of the femoral canal and performing femoral and tibial saw cuts, then we detected echogenic emboli in all 20 patients during tourniquet deflation. Echogenic emboli consistently filled the right atrium and ventricle with very small size embolic materials for 19士7 minutes during total knee replacement. Heart rate exhibited no change, Mean arterial pressure decreased and mean pulmonary artery pressure increased after tourniquet deflation. After tourniquet deflation, free fatty acid increased in lipid profile. No patient had postoperative complications related echogenic emboli.
Conculusions: All patients exhibited echogenic emboli during certain stages of total knee replacement. Although all patients were asymtomatic in our study, one should be cautioned when performing total knee replacement in patients with little physiologic reserve and large embolic events. (Korean J Anesthesiol 1998; 34: 1150-1156)
Alternative Title
Transesophageal Echocardiography Monitored Emobolic Events during the Total Knee Replacemnet: Hemodynamic Changes and Emobolic Composition
Keimyung Author(s)(Kor)
김진모
Publisher
School of Medicine
Citation
김진모 et al. (1998). 인공 슬관절 전치환술 중 경식도 초음파 감시하의 색전 출현: 혈역학적 변화와 색전의 구성. 대한마취과학회지, 34(6), 1150–1156. doi: 10.4097/kjae.1998.34.6.1150
Type
Article
ISSN
0302-5780
DOI
10.4097/kjae.1998.34.6.1150
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/40086
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Anesthesiology & Pain Medicine (마취통증의학)
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