Acute and Critical Care

Anesthesiology/Pediatric
Aspiration Pneumonia in a Pediatric Patient under General Anesthesia despite Adequate Preoperative Fasting: Sang-Il Yoon, Jong-Man Kang; Korean J Crit Care Med. 2015;30(4):313-317. Published online November 30, 2015; DOI: https://doi.org/10.4266/kjccm.2015.30.4.313

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Aspiration pneumonia rarely occurs during general anesthesia; however, it can result in fatal pulmonary complications. To reduce aspiration pneumonia, a preoperative fasting time of 8 hours is recommended. A 4-year-old boy with ankyloglossia was scheduled for frenotomy. He completed preoperative fasting time and had no digestive symptoms. Pulmonary aspiration due to unexpected massive vomiting occurred during anesthesia induction. The patient’s airway was immediately secured by endotracheal tube. The vomitus in the airway tract was removed by fiberoptic bronchoscopy. Abdomen radiograph taken after this event showed paralytic ileus which can cause aspiration of gastric contents. We describe a case of pneumonia caused by aspiration of gastric contents in a pediatric patient who followed fasting instructions and who was scheduled for outpatient surgery.

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Factors associated with bronchopulmonary aspiration: a national-based study
Jaqueline Helena Tanner, Cristina Mara Zamarioli, Magda Machado de Miranda Costa, Heiko Thereza Santana, Ana Clara Ribeiro Bello dos Santos, Cleide Felicia de Mesquita Ribeiro, Fernanda Raphael Escobar Gimenes
Revista Brasileira de Enfermagem.2022;[Epub] CrossRef

Severe Hypernatremia with Craniopharyngioma - A Case Report -: Jun Bum Park, Se Hun Park, Eun Hui Seo, Hyun Seok Park, Jin Kyu Jeong; Korean J Crit Care Med. 2013;28(1):46-50.; DOI: https://doi.org/10.4266/kjccm.2013.28.1.46

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Abstract PDF: Hypernatremia, defined as a rise in the serum sodium concentration to a value exceeding 145 mM/L, is a common electrolyte disorder. Diabetes insipidus is a common cause of hypernatremia, caused by impaired production or reduced responses to vasopressin. The resultant morbidity may be inconsequential, serious, or even life-threatening. However, hypernatremia rarely occurs during anesthesia and surgery. A 45-year-old female patient with craniopharyngioma was scheduled for tumor resection. Hypernatremia (serum sodium, 170 mM/L) occurred suddenly at the end of the surgery. To treat hypernatremia, 0.45% normal saline was used. Although serum sodium concentration was reduced faster than expected, the patient did not have any complications.

Unexpected Intra-operative Pulmonary Thromboemolism during Elective Mastoidectomy: A Case Report: Hyun Jeong Kwak, Hee Yeon Park, Hong Soon Kim, Sung Ho Choi, Kyung Cheon Lee; Korean J Crit Care Med. 2009;24(3):160-163.; DOI: https://doi.org/10.4266/kjccm.2009.24.3.160

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Abstract PDF: We report on a 45-year-old patient who sustained an intra-operative pulmonary thromboembolism during elective mastoidectomy under general anesthesia. At the end of surgery, the patient developed hemodynamic compromise and exhibited T wave inversion on electrocardiogram. Echocardiography showed an echogenic mass in the right pulmonary artery and pulmonary hypertension. Pulmonary thromboembolism is rare in the field of otolaryngology and head and neck surgery; however, it may develop, resulting in a fatal outcome. It is thus important to establish the diagnosis early and prevent such serious complications.

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