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最重症COPD合併症例に対する弓部全置換術後に陽・陰圧体外式人工呼吸器(RTX)と非侵襲的陽圧換気(NPPV)が有効であった1例
http://hdl.handle.net/10271/620
http://hdl.handle.net/10271/62096c3d49a-8b22-4ff5-bb4e-928fcb542555
名前 / ファイル | ライセンス | アクション |
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110006632900.pdf (1.1 MB)
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Item type | 学術雑誌論文 / Journal Article(1) | |||||
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公開日 | 2013-08-27 | |||||
タイトル | ||||||
言語 | ja | |||||
タイトル | 最重症COPD合併症例に対する弓部全置換術後に陽・陰圧体外式人工呼吸器(RTX)と非侵襲的陽圧換気(NPPV)が有効であった1例 | |||||
言語 | ||||||
言語 | jpn | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | 慢性閉塞性肺疾患 | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | 弓部全置換術 | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | 陽・陰圧体外式人工呼吸器 | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | 非侵襲的陽圧換気 | |||||
資源タイプ | ||||||
資源タイプ識別子 | http://purl.org/coar/resource_type/c_6501 | |||||
資源タイプ | journal article | |||||
その他のタイトル | ||||||
その他のタイトル | Effectiveness of Assisted Ventilation Supplemented by RTX and NPPV for the Prevention of Postoperative Respiratory Failure in a Patient with Severe COPD Undergoing Total Arch Replacement | |||||
著者 |
寺田, 仁
× 寺田, 仁× 鷲山, 直己× 大倉, 一宏× 阿久澤, 聡 |
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書誌情報 |
日本心臓血管外科学会雑誌 巻 37, 号 2, p. 112-115, 発行日 2008-03-15 |
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出版者 | ||||||
出版者 | 日本心臓血管外科学会 | |||||
権利 | ||||||
権利情報 | 日本心臓血管外科学会 | |||||
権利 | ||||||
権利情報 | 本文データは学協会の許諾に基づきCiNiiから複製したものである | |||||
抄録 | ||||||
内容記述タイプ | Abstract | |||||
内容記述 | 症例は74歳,男性.以前より遠位弓部大動脈瘤を指摘されていたが,拡大傾向を認めたため手術目的に紹介入院となった.画像上遠位弓部大動脈に頭側に突出する最大径65mmの嚢状動脈瘤を認めた.また,入院時Hugh-Jones分類IV度の呼吸障害と気管支喘息を合併しており,呼吸機能検査で1秒量が初回時0.57l,再検時0.49lと低値で,Stage IVの最重症慢性閉塞性肺疾患(COPD)を認めた.本症例に対して待機的に弓部大動脈全置換術(TAR)を施行した.術後2日目に呼吸離脱を図ったが,呼吸不全が顕著となり陽・陰圧体外式人工呼吸器(respiratory therapy external:RTX)を装着し,その後BiPAPを用いた非侵襲的陽圧換気(non-invasive positive pressure ventilation:NPPV)と併用して再挿管を回避,周術期呼吸不全をのりきった.重症COPDを合併した症例に対するTAR後呼吸不全に対して,RTXとNPPVを併用した補助呼吸療法は有効であり,周術期管理に役立つと考えられた. A 74-year-old man with very severe chronic obstructive pulmonary disease (COPD) was scheduled for elective total arch replacement for a distal arch saccular aneurysm. Postoperative respiratory failure was anticipated because of a marked reduction in forced expiratory volume in one second (FEV_<1.0>- less than 0.5 l). Through median sternotomy, total arch replacement using selective cerebral perfusion was completed uneventfully. Postoperative respiratory condition was stable. Therefore, the patient was extubated on postoperative day 2 (POD 2). However, as the respiratory condition started getting worse, respiratory therapy external (RTX) was introduced to assist ventilation. Additionally, non-invasive positive pressure ventilation (NPPV) with BiPAP was used on POD 3 and management with both RTX and NPPV was continued during the remainder of the intensive care unit stay. As a result, we were able to avoid re-intubation. In conclusion, assisted ventilation supplemented by RTX and NPPV was useful for the prevention of postoperative respiratory failure in a patient with very severe COPD undergoing total arch replacement. | |||||
ISSN | ||||||
収録物識別子タイプ | ISSN | |||||
収録物識別子 | 02851474 | |||||
NII論文ID | ||||||
関連タイプ | isIdenticalTo | |||||
識別子タイプ | NAID | |||||
関連識別子 | 110006632900 | |||||
著者版フラグ | ||||||
出版タイプ | VoR | |||||
出版タイプResource | http://purl.org/coar/version/c_970fb48d4fbd8a85 |