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Foot Necrosis Following Percutaneous Cannulation of the Dorsalis Pedis Artery: A Case Report
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Hyun Young Lee, Bo Yeon Yu, Sang Hun Kim, Tae Hun An, Chuog Dal Chung, Byung Sik Yu, Keum Young So, Kyung Joon Lim, Nam Soo Cho
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Korean J Crit Care Med. 2009;24(3):156-159.
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DOI: https://doi.org/10.4266/kjccm.2009.24.3.156
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 Abstract
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- Arterial canuulation is generally used to monitor blood pressure and sample blood for gas analysis. Radial and dorsalis pedis arteries are commonly used for arterial cannulation. It is a simple, safe, and uncomplicated procedure, but some complications have been reported, including bleeding, hematoma, infection, pseudoaneurysm, and thromboembolism. Although thromboembolism is not common, it could be serious because it can lead to digital ischemia and necrosis. We present a case of foot necrosis following dorsalis pedis artery cannulation in a 65-year-old patient who underwent small bowel resection.
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Acute Respiratory Arrest and Brain Sequale Ocurred after General Anesthesia in Diabetic Autonomic Neuropathy Patient: A Case Report
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Tae Hun An, Tae Hyeong Kim, Byung Sik Yu
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Korean J Crit Care Med. 2004;19(2):130-133.
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Abstract
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- The incidence of autonomic neuropathy is high in diabetic patients. Cardiovascular complications including sudden cardiorespiratory arrest, bradycardia, hypotension can occur in diabetic patients complicated with autonomic neuropathy.
The causes of sudden deaths in diabetics may not always be due to silent myocardial infarction but may also be due to autonomic neuropathy. Patients with diabetic autonomic neuropathy are less able to withstand hypoxia compare to normal people due to sympathetic nerve system damage. We present a case of acute respiratory arrest that occured in a 38 years old diabetic autonomic neuropathy patient after general anesthesia. Even though the patient was carried rapid and adequate airway management within 5 minutes, the patient had severe brain sequale. We conclude that the diabetic autonomic neuropathy patients require more careful monitoring and management for the hypoxia and cardiovascular status because they are more sensitive in hypoxia.
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Mechanical Ventilation in Patients with Chronic Obstructive Pulmonary Disease
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Tae Hun An
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Korean J Crit Care Med. 2003;18(2):67-73.
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Abstract
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- Patients with severe chronic obstructive pulmonary disease (COPD) may require mechanical ventilation following cardiac or general surgery, in connection with thoracic surgery such as lobectomy, wedge resection, lung reduction or bullectomy, during an episode of acute respiratory failure (ARF) secondary to a disease other than COPD such as sepsis, drug overdose, or trauma or for acute-on-chronic respiratory failure (the COPD exacerbation) where acute illness, usually presumed to be infectious in nature, destabilizes the characteristically compensated state. Ventilatory intervention is often life-saving when patients with asthma or COPD experience acute respiratory compromise. Although both noninvasive and invasive ventilation methods may be viable initial choice, which is better depends upon the severity of illness, the rapidity of response, coexisting disease, and capacity of the medical environment. In addition, noninvasive ventilation often relieves dyspnea and hypoxemia in patients with stable severe COPD. This review will only briefly cover noninvasive ventilation and focus primarily on the management of the intubated, mechanically ventilated patient with COPD, with particular emphasis on factors unique to this patient population such as the propensity for dynamic hyperinflation and auto-PEEP, barotrauma, difficult weaning and the prognosis following mechanical ventilation.
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