Acute and Critical Care

Yun Mi Choi

2 Articles

Surgery
Iatrogenic Intramural Dissection of the Esophagus after Insertion of a Laryngeal Mask Airway: Hee Young Kim, Seung-Hoon Baek, Yong Hoon Cho, Joo-Yun Kim, Yun Mi Choi, Eun Ji Choi, Jung Pil Yoon, Jung Hyun Park; Acute Crit Care. 2018;33(4):276-279. Published online June 30, 2017; DOI: https://doi.org/10.4266/acc.2016.00829

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In pediatric patients, a laryngeal mask airway (LMA) is usually used during minor surgeries that require general anesthesia. No esophageal injury has been reported after insertion of an LMA. We report a case of an esophageal injury with intramural dissection after an i-gel^® (size, 1.5; Intersurgical Ltd.) insertion in a pediatric patient. A 2-month-old male infant was hospitalized for left inguinal herniorrhaphy. After induction of anesthesia, a trained resident tried to insert an i-gel^® . However, it was only successful after three attempts. Dysphagia was sustained until postoperative day 10, and the pediatrician observed duplication of the esophagus on gastroendoscopy. However, a whitish mucosal lesion, which looked like a scar, was observed, and previous lesions suggestive of esophageal duplication were almost healed on postdischarge day 11. His condition was diagnosed as dysphagia and esophagitis due to an esophageal laceration, not esophageal duplication. He was scheduled for symptomatic treatment with a proton pump inhibitor. In conclusion, although an esophageal injury or perforation in pediatric patients is rare, an LMA insertion or a procedure such as aspiration or nasogastric tube insertion should be performed gently to avoid a possible injury to the esophagus in pediatric patients.

Citations

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Yin-Xiao Chen, Jie Lin, Xian-Hua Ye, Xian-Da Zhao, Qun-Xin Yan
Medicine.2022; 101(52): e32388. CrossRef
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Nephrology
The Association of Preoperative Body Mass Index with Acute Kidney Injury in Liver Transplantation Recipients: A Retrospective Study: Ju Yeon Park, Jung-Hyun Park, Su Sung Lee, Hyun-Su Ri, Hye-jin Kim, Yun Mi Choi, Yoon Ji Choi, Ji-Uk Yoon; Korean J Crit Care Med. 2017;32(3):265-274. Published online August 31, 2017; DOI: https://doi.org/10.4266/kjccm.2017.00178

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Abstract PDF

Background
Liver transplantation (LT) is a complicated procedure with a high incidence of postoperative acute kidney injury (AKI). Previous studies indicate that even transient or mild post-LT AKI can result in critical conditions, including prolonged stays in hospitals and intensive care units and increased morbidity and mortality. The aim of this study was to investigate the association between body mass index (BMI) and occurrence of AKI in LT recipients. Methods: Medical data from 203 patients who received LT surgery from January 2010 to August 2016 in a single university hospital setting were retrospectively collected and analyzed. Patients were classified as either underweight (BMI <20 kg/m²) or normal weight (20 ≤ BMI < 30 kg/m²). Demographic data, anesthetic methods, complications, and perioperative laboratory test values of each patient were assessed. Propensity analyses and logistic regression were performed to evaluate the association between BMI and post-LT AKI. Results: There was no significant difference in occurrence of post-LT AKI between underweight and normal weight patients. The underweight patient group had significantly longer hospital stay compared with the normal weight patient group (P = 0.023). Conclusions: BMI classification was neither a positive nor negative predictor of postoperative AKI occurrence. However, patients with lower BMI had significantly longer hospital stay compared with their counterparts. Although our study was limited by its retrospective design, our observations suggest that lower BMI might play a role in post-LT AKI.

Citations

Citations to this article as recorded by

Association of Body Mass Index and Acute Kidney Injury Incidence and Outcome: A Systematic Review and Meta-Analysis
Jiarong Lan, Guangxing Xu, Yongfu Zhu, Congze Lin, Ziyou Yan, Sisi Shao
Journal of Renal Nutrition.2023; 33(3): 397. CrossRef
Association of overweight with postoperative acute kidney injury among patients receiving orthotopic liver transplantation: an observational cohort study
Jian Zhou, Lin Lyu, Lin Zhu, Yongxin Liang, He Dong, Haichen Chu
BMC Nephrology.2020;[Epub] CrossRef

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