Acute and Critical Care

Byung Ho Lee

3 Articles

The Risk Factors of Postoperative Respiratory Insufficiency after Prolonged Robotic Radical Prostatectomy: Jin Young Lee, Ji Young Lee, Sung Jin Hong, Byung Ho Lee, Ou Kyoung Kwon, Young Hee Kim; Korean J Crit Care Med. 2010;25(3):130-135.; DOI: https://doi.org/10.4266/kjccm.2010.25.3.130

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BACKGROUND
Robotic radical prostatectomy is performed in elderly patients and requires extreme changes in the patient's position and is often associated with a long surgery time. This study reviewed the pulmonary complications occurring after a robotic radical prostatectomy and analyzed the potential risk factors.
METHODS
The medical records of all patients who had undergone robotic radical prostatectomy at our institution were reviewed. Among the 80 total patients, 58 were capable of spontaneous respiration at the end of surgery (Group I), whereas 22 patients required assisted ventilation (Group II). A comparison between the two groups was made in terms of the demographic characteristics, coexisting diseases, anesthesia and operation time, amount of intraoperative blood loss and transfused blood products.
RESULTS
The mean age of the patients was 67.2 +/- 7.3 years. The mean operation time was 384.1 +/- 203.4 min (range, 195-1,180 min). The anesthesia and operation time, amount of intraoperative blood loss and number of transfused patients were all significantly higher in Group II. Univariate analysis revealed age, body mass index, intraoperative blood loss and transfusion, anesthesia and operation time to be related to postoperative respiratory insufficiency. Multivariate analysis revealed intraoperative transfusion and operation time to be predictive risk factors.
CONCLUSIONS
Prolonged laparoscopic surgery in a steep Trendelenburg position has a high likelihood of postoperative respiratory insufficiency, with the intraoperative transfusion and a longer operation time being possible contributing factors.

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Features of the mechanics of respiration and gas exchange during robot-assisted radical prostatectomy. Review
Ildar I. Lutfarakhmanov, I. A. Melnikova, E. Yu. Syrchin, V. F. Asadullin, Yu. A. Korelov, P. I. Mironov
Annals of Critical Care.2021; (1): 75. CrossRef

Intracardiac Knotting of a Balloon-tipped, Flow-directed Pulmonary Artery Catheter: A Case Report: Bong Chul Choi, Mee Young Chung, Chang Jae Kim, Jun Seuk Chea, Byung Ho Lee; Korean J Crit Care Med. 2005;20(2):178-182.

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Abstract PDF: The occurrence of knots and loops is a potential hazard of a balloon-tipped, flow-directed pulmonary artery (PA) catheter placement if excessive catheter length is passed into the right atrium or ventricle. Knotting of a balloon-tipped, flow-directed PA catheter leading to difficulty in its removal is a rare but serious complication. A case of knotted catheter in right atrium in a patient undergoing aortic valve replacement is presented. By passing a spring guidewire into PA catheter, we have untied the loose knotted catheter under simple fluoroscopic guidance in the intensive care unit.

The Comparison of Buccal SpO2 and Finger SpO2 Accuracy in Patients with Moderate Defect in Pulmonary Function Test: Mee Young Chung, Jun Seuk Chea, Chang Jae Kim, Byung Ho Lee, Seung Ho Joo; Korean J Crit Care Med. 2000;15(1):31-34.

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Abstract PDF: BACKGROUND
The reliability of pulse oxymetry probes when applied to the finger or toes may be compromised in certain patients. Other sites less subject to mechanical interference or a pathophysiologic decrease in pulse amplitude have been sought. In the patients with moderate defect (N=20) in pulmonary function test, we examined the accuracy of buccal and digital SpO2 (oxygen saturation of pulse oxymetry) monitoring.
METHODS
SpO2 probe was placed firmly in the corner of the patient's mouth. Buccal and finger SpO2 and radial SaO2 (arterial oxygen saturation) were measured before the induction of anesthesia. The agreement between SaO2 and each SpO2 were calculated with the method outlined by Bland and Altman.
RESULTS
Buccal SpO2 was higher than finger SpO2, but finger SpO2 agreed more closely with SaO2 (buccal; 97.9+/-1.89, finger; 94.5+/-2.48, radial; 93.73+/-2.73%).
CONCLUSIONS
We conclude that buccal SpO2 monitoring may offer alternative when other sites aren't available. But, we suggest that buccal SpO2 should be further evaluated for the accuracy.

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