{"created":"2023-06-20T15:46:06.163369+00:00","id":590,"links":{},"metadata":{"_buckets":{"deposit":"fefb5e6c-b1c7-404c-b0dc-983ef1309e99"},"_deposit":{"created_by":4,"id":"590","owners":[4],"pid":{"revision_id":0,"type":"depid","value":"590"},"status":"published"},"_oai":{"id":"oai:hama-med.repo.nii.ac.jp:00000590","sets":["1:11"]},"author_link":["1826","1827","1828","1829"],"item_3_alternative_title_1":{"attribute_name":"その他のタイトル","attribute_value_mlt":[{"subitem_alternative_title":"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"}]},"item_3_biblio_info_5":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2008-03-15","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"2","bibliographicPageEnd":"115","bibliographicPageStart":"112","bibliographicVolumeNumber":"37","bibliographic_titles":[{"bibliographic_title":"日本心臓血管外科学会雑誌"}]}]},"item_3_description_9":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"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.","subitem_description_type":"Abstract"}]},"item_3_publisher_6":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"日本心臓血管外科学会"}]},"item_3_relation_22":{"attribute_name":"NII論文ID","attribute_value_mlt":[{"subitem_relation_type":"isIdenticalTo","subitem_relation_type_id":{"subitem_relation_type_id_text":"110006632900","subitem_relation_type_select":"NAID"}}]},"item_3_rights_7":{"attribute_name":"権利","attribute_value_mlt":[{"subitem_rights":"日本心臓血管外科学会"},{"subitem_rights":"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"}]},"item_3_source_id_19":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"02851474","subitem_source_identifier_type":"ISSN"}]},"item_3_version_type_32":{"attribute_name":"著者版フラグ","attribute_value_mlt":[{"subitem_version_resource":"http://purl.org/coar/version/c_970fb48d4fbd8a85","subitem_version_type":"VoR"}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"寺田, 仁"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"鷲山, 直己"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"大倉, 一宏"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"阿久澤, 聡"}],"nameIdentifiers":[{}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2018-08-27"}],"displaytype":"detail","filename":"110006632900.pdf","filesize":[{"value":"1.1 MB"}],"format":"application/pdf","licensetype":"license_note","mimetype":"application/pdf","url":{"label":"110006632900.pdf","url":"https://hama-med.repo.nii.ac.jp/record/590/files/110006632900.pdf"},"version_id":"423b22bc-e7cb-49ab-b954-25b73b5c9fa7"}]},"item_keyword":{"attribute_name":"キーワード","attribute_value_mlt":[{"subitem_subject":"慢性閉塞性肺疾患","subitem_subject_scheme":"Other"},{"subitem_subject":"弓部全置換術","subitem_subject_scheme":"Other"},{"subitem_subject":"陽・陰圧体外式人工呼吸器","subitem_subject_scheme":"Other"},{"subitem_subject":"非侵襲的陽圧換気","subitem_subject_scheme":"Other"}]},"item_language":{"attribute_name":"言語","attribute_value_mlt":[{"subitem_language":"jpn"}]},"item_resource_type":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"resourcetype":"journal article","resourceuri":"http://purl.org/coar/resource_type/c_6501"}]},"item_title":"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","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"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","subitem_title_language":"ja"}]},"item_type_id":"3","owner":"4","path":["11"],"pubdate":{"attribute_name":"PubDate","attribute_value":"2013-08-27"},"publish_date":"2013-08-27","publish_status":"0","recid":"590","relation_version_is_last":true,"title":["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"],"weko_creator_id":"4","weko_shared_id":-1},"updated":"2023-08-02T05:47:59.230906+00:00"}