Acute and Critical Care

Original Article

Pulmonary
Cinematic virtual reality for anxiety management in mechanically ventilated patients: a feasibility and pilot study: Alexander C. Haley, David A. Wacker; Acute Crit Care. 2022;37(2):230-236. Published online February 4, 2022; DOI: https://doi.org/10.4266/acc.2021.00843

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Background
Mechanically ventilated patients experience anxiety for many reasons. Pharmacological treatments such as benzodiazepines are commonly employed to manage anxiety; however, these therapies often cause undesired side effects. Additional therapies for anxiety management are needed. We sought to determine whether cell phone-based virtual reality therapy could feasibly be used for anxiety management in mechanically ventilated patients.
Methods
Mechanically ventilated subjects underwent at least one session of virtual reality therapy in which they were shown a cinematic video of an outdoor green space or blue space with 360° visual range of motion. Goal session duration was 5 minutes. The primary outcome was incidence of predefined patient safety events, including self-extubation and accidental removal of tubes or lines.
Results
Ten subjects underwent a total of 18 virtual reality sessions. Fifteen sessions lasted the planned 5 minutes, one session was extended at participant request, and two sessions were terminated early at participant request. There were no occurrences of the predefined safety events, and no occurrences of cybersickness. Use of a visual analog scale to measure anxiety level was feasible for this pilot study, demonstrating feasibility of this scale for future, larger scale studies.
Conclusions
Virtual reality therapy shows potential as a means of managing anxiety in patients undergoing mechanical ventilation, and further rigorous exploration with this protocol is feasible.

Citations

Citations to this article as recorded by

Opportunities for Managing Pain and Anxiety in the Intensive Care Unit Using Virtual Reality: Perspectives from Bedside Care Providers
Isabella P. Garito, Samantha Lewis-Fung, Brenna Lawson, Hannah Gabrielle Gray, Christopher Smith, Lora Appel
Journal of Medical Extended Reality.2024; 1(1): 53. CrossRef
Immersive Virtual Reality Use in Medical Intensive Care: Mixed Methods Feasibility Study
Brian W Locke, Te-yi Tsai, C Mahony Reategui-Rivera, Aileen S Gabriel, Aref Smiley, Joseph Finkelstein
JMIR Serious Games.2024; 12: e62842. CrossRef
Virtual Reality Therapy for People With Epilepsy and Related Anxiety: Protocol for a 3-Phase Pilot Clinical Trial
Hannah Gabrielle Gray, Danielle Tchao, Samantha Lewis-Fung, Susanna Pardini, Laurence R Harris, Lora Appel
JMIR Research Protocols.2023; 12: e41523. CrossRef
Virtual and augmented reality in intensive care medicine: a systematic review
Dominika Kanschik, Raphael Romano Bruno, Georg Wolff, Malte Kelm, Christian Jung
Annals of Intensive Care.2023;[Epub] CrossRef
A study to assess the communication and level of anxiety among mechanically ventilated conscious patients in intensive care units of sree mookambika medical college hospital at kanyakumari district
Derlin A. Ahisha, Retnam C. Ajitha
i-manager's Journal on Nursing.2023; 13(2): 20. CrossRef

Case Report

Cardiology
Percutaneous bicaval dual lumen cannula for extracorporeal life support: Woojung Kim, Hye Won Kwon, Jooncheol Min, Sungkyu Cho, Jae Gun Kwak, June Dong Park, Woong-Han Kim; Acute Crit Care. 2020;35(3):207-212. Published online September 23, 2019; DOI: https://doi.org/10.4266/acc.2019.00584

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Abstract PDF

Veno-venous extracorporeal membrane oxygenation (ECMO) is a useful mechanical device for pediatric patients with severe respiratory failure. Conventional veno-venous ECMO using double cannulation, however, is not feasible due to size limitations in pediatric patients who have small femoral vessels. Recently, percutaneous bicaval dual-lumen cannula can be inserted using single cannulation via the right internal jugular vein. Herein, we report the case of a pediatric patient with severe respiratory failure who was weaned off the ECMO successfully after treatment with bicaval dual-lumen cannulation for 5 days despite the small body size and immunocompromised condition due to chemotherapy for hemophagocytic lymphohistiocytosis.

Citations

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Lipid Emulsion Treatment for Drug Toxicity Caused by Nonlocal Anesthetic Drugs in Pediatric Patients
Soo Hee Lee, Sunmin Kim, Ju-Tae Sohn
Pediatric Emergency Care.2023; 39(1): 53. CrossRef
Mechanisms underlying lipid emulsion resuscitation for drug toxicity: a narrative review
Soo Hee Lee, Ju-Tae Sohn
Korean Journal of Anesthesiology.2023; 76(3): 171. CrossRef

Original Article

Pulmonary
Reduction of PaCO₂ by high-flow nasal cannula in acute hypercapnic respiratory failure patients receiving conventional oxygen therapy: Hyun Woo Lee, Sun Mi Choi, Jinwoo Lee, Young Sik Park, Chang-Hoon Lee, Chul-Gyu Yoo, Young Whan Kim, Sung Koo Han, Sang-Min Lee; Acute Crit Care. 2019;34(3):202-211. Published online August 31, 2019; DOI: https://doi.org/10.4266/acc.2019.00563

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Abstract PDF

Background
It has been suggested that a high-flow nasal cannula (HFNC) could help to remove carbon dioxide (CO₂) from anatomical dead spaces, but evidence to support that is lacking. The objective of this study was to elucidate whether use of an HFNC could reduce the arterial partial pressure of CO₂ (PaCO₂) in patients with acute hypercapnic respiratory failure who are receiving conventional oxygen (O₂) therapy.
Methods
A propensity score-matched observational study was conducted to evaluate patients treated with an HFNC for acute hypercapnic respiratory failure from 2015 to 2016. The hypercapnia group was defined as patients with a PaCO₂ >50 mm Hg and arterial pH <7.35.
Results
Eighteen patients in the hypercapnia group and 177 patients in the nonhypercapnia group were eligible for the present study. Eighteen patients in each group were matched by propensity score. Decreased PaCO₂ and consequent pH normalization over time occurred in the hypercapnia group (P=0.002 and P=0.005, respectively). The initial PaCO₂ level correlated linearly with PaCO₂ removal after the use of an HFNC (R²=0.378, P=0.010). The fraction of inspired O₂ used in the intensive care unit was consistently higher for 48 hours in the nonhypercapnia group. Physiological parameters such as respiratory rate and arterial partial pressure of O₂ improved over time in both groups.
Conclusions
Physiological parameters can improve after the use of an HFNC in patients with acute hypercapnic respiratory failure given low-flow O₂ therapy via a facial mask. Further studies are needed to identify which hypercapnic patients might benefit from an HFNC.

Citations

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Efficacy and safety of high-flow nasal cannula therapy in elderly patients with acute respiratory failure
J.M. Carratalá, S. Diaz-Lobato, B. Brouzet, P. Más-Serrano, J.L.S. Rocamora, A.G. Castro, A.G. Varela, S.M. Alises
Pulmonology.2024; 30(5): 437. CrossRef
Comparison of preoxygenation with a high-flow nasal cannula and a simple face mask before intubation in patients with head and neck cancer
Jun-Young Jo, Jungpil Yoon, Heeyoon Jang, Wook-Jong Kim, Seungwoo Ku, Seong-Soo Choi
Acute and Critical Care.2024; 39(1): 61. CrossRef
Successful noninvasive ventilation in a severely acidotic and hypercapnic comatose COVID-19 patient with multiple comorbidities: a case report
Joseph Abraham Poonuraparampil, Habib Md Reazaul Karim, Manu P Kesavankutty, Porika Prashanth Nayak
Acute and Critical Care.2022; 37(1): 120. CrossRef
Comparison of Conventional Oxygen Therapy With High-Flow Nasal Oxygenation in the Management of Hypercapnic Respiratory Failure
Jitendra Pratap Singh, Deepak Malviya, Samiksha Parashar, Soumya Sankar Nath, Archana Gautam, Neha Shrivastava
Cureus.2022;[Epub] CrossRef
Current Considerations in Emergency Airway Management
Andrew Pirotte, Vivek Panchananam, Matthew Finley, Austin Petz, Tom Herrmann
Current Emergency and Hospital Medicine Reports.2022; 10(4): 73. CrossRef
S/F and ROX indices in predicting failure of high‐flow nasal cannula in children
Ji Hye Kim, Dong In Suh, June Dong Park
Pediatrics International.2022;[Epub] CrossRef
Nasal High‐flow Oxygen Versus Conventional Oxygen Therapy for Acute Severe Asthma Patients: A Pilot Randomized Controlled Trial
Onlak Ruangsomboon, Chok Limsuwat, Nattakarn Praphruetkit, Apichaya Monsomboon, Tipa Chakorn, Brian C. Hiestand
Academic Emergency Medicine.2021; 28(5): 530. CrossRef
Flow Field Analysis of Adult High‐Flow Nasal Cannula Oxygen Therapy
Jingen Xia, Jiaqi Chang, Jixiang Liang, Yixuan Wang, Na Wang, Bo Xiao
Complexity.2021;[Epub] CrossRef
Treatment of Severe Acute on Chronic Liver Failure
Aarshi Vipani, Christina C. Lindenmeyer, Vinay Sundaram
Journal of Clinical Gastroenterology.2021; 55(8): 667. CrossRef
Efficacy of High-Flow Nasal Cannula Oxygen Therapy in Patients with Mild Hypercapnia
Lingling Su, Qinyu Zhao, Taotao Liu, Yujun Xu, Weichun Li, Aiping Zhang
Lung.2021; 199(5): 447. CrossRef
High-Flow Nasal Cannula Oxygen Therapy Can Be Effective for Patients in Acute Hypoxemic Respiratory Failure with Hypercapnia: a Retrospective, Propensity Score-Matched Cohort Study
SooHyun Bae, Minkyu Han, Changyoung Kim, Hyeji Lee, Jong-Joon Ahn, Jin Hyoung Kim, Byung Ju Kang
Journal of Korean Medical Science.2020;[Epub] CrossRef
High-flow nasal cannula oxygen therapy as an emerging option for respiratory failure: the present and the future
Lucia Spicuzza, Matteo Schisano
Therapeutic Advances in Chronic Disease.2020;[Epub] CrossRef
Impact of High-Flow Nasal Cannula on Arterial Blood Gas Parameters in the Emergency Department
Emre Şancı, Feride Ercan Coşkun, Basak Bayram
Cureus.2020;[Epub] CrossRef

Case Reports

Pulmonary
Right ventricular assist device with an oxygenator using extracorporeal membrane oxygenation as a bridge to lung transplantation in a patient with severe respiratory failure and right heart decompensation: Dong Kyu Oh, Tae Sun Shim, Kyung-Wook Jo, Seung-Il Park, Dong Kwan Kim, Sehoon Choi, Geun Dong Lee, Sung-Ho Jung, Pil-Je Kang, Sang-Bum Hong; Acute Crit Care. 2020;35(2):117-121. Published online April 8, 2019; DOI: https://doi.org/10.4266/acc.2018.00416

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Abstract PDF

Right heart decompensation is a fatal complication in patients with respiratory failure, particularly in those transitioned to lung transplantation using veno-venous extracorporeal membrane oxygenation (V-V ECMO). In these patients, veno-arterial (V-A ECMO) or veno-arterialvenous extracorporeal membrane oxygenation (V-AV ECMO) is used to support both cardiac and respiratory function. However, these processes may increase the risk of device-related complications such as bleeding, thromboembolism, and limb ischemia. In the present case, a 64-year-old male patient with idiopathic pulmonary fibrosis developed respiratory failure and commenced treatment with V-V ECMO as a bridge to lung transplantation. Unfortunately, the patient developed right heart decompensation and required both cardiac and respiratory support during treatment with V-V ECMO. Instead of adding arterial cannulation, he was switched to a novel configuration, a right ventricular assist device with an oxygenator (Oxy- RVAD) using ECMO, with drainage cannulation from the femoral vein and return cannulation to the main pulmonary artery. The patient was successfully bridged to lung transplantation without serious complications after 10 days of Oxy-RVAD support. To the best of our knowledge, this is an extreme rare and challenging case of Oxy-RVAD using ECMO in a patient successfully bridged to lung transplantation.

Citations

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The Role of Palliative Care in Cardiovascular Disease
John Arthur McClung, William H. Frishman, Wilbert S. Aronow
Cardiology in Review.2024;[Epub] CrossRef
Percutaneous Venopulmonary Extracorporeal Membrane Oxygenation as Bridge to Lung Transplantation
Asad Ali Usman, Audrey Elizabeth Spelde, Wasim Lutfi, Jacob T. Gutsche, William J. Vernick, Omar Toubat, Salim E. Olia, Edward Cantu, Andrew Courtright, Maria M. Crespo, Joshua Diamond, Mauer Biscotti, Christian A. Bermudez
ASAIO Journal.2024; 70(9): 758. CrossRef
Right Ventricular Assist Device With an Oxygenator for the Management of Combined Right Ventricular and Respiratory Failure: A Systematic Review
Juliette Beaulieu, Christine Vu, Sanjog Kalra, Hamza Ouazani Chahdi, Julie Cousineau, Alexis Matteau, Samer Mansour, E. Marc Jolicoeur, Sabrina Jacques, Bénédicte Nauche, Renata Podbielski, Pasquale Ferraro, Charles Poirier, Brian J. Potter
Canadian Journal of Cardiology.2024; 40(9): 1732. CrossRef
Percutaneous OxyRVAD in a Patient with Severe Respiratory Failure and Right Heart Failure: A Case Report
Ga Young Yoo, June Lee, Seok Beom Hong, Do Yeon Kim
Journal of Chest Surgery.2024; 57(3): 319. CrossRef
Central Venopulmonary Extracorporeal Membrane Oxygenation: Background and Standardized Nomenclature
J. Michael Brewer, Roberto Lorusso, L. Mikael Broman, Steven A. Conrad, Justyna Swol, Marc O. Maybauer
ASAIO Journal.2024; 70(9): e123. CrossRef
Outcomes of Lung Transplantation in Patients With Right Ventricular Dysfunction: A Single-Center Retrospective Analysis Comparing ECMO Configurations in a Bridge-to-Transplant Setting
Su Yeon Lee, Jee Hwan Ahn, Ho Cheol Kim, Tae Sun Shim, Pil-Je Kang, Geun Dong Lee, Se Hoon Choi, Sung-Ho Jung, Seung-Il Park, Sang-Bum Hong
Transplant International.2024;[Epub] CrossRef
Early Mobilization for a Patient With a Right Ventricular Assist Device With an Oxygenator
Sheena MacFarlane, Vanessa Lee, Adrienne H. Simonds, Samantha Alvarez, Samantha Carty, Kevin H. Ewers, Victoria R. Kelly, Parker Linden, Amanda L. Moskal
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A 35-month-old boy who ingested laundry detergent pods and underwent veno-pulmonary extracorporeal membrane oxygenation support
Hye-ji Han, Bongjin Lee, Won Jin Jang, Ji Won Lee, Jin Hee Kim, Sungkyu Cho, June Dong Park
Pediatric Emergency Medicine Journal.2023; 10(4): 175. CrossRef
Right Ventricular Assist Device With Extracorporeal Membrane Oxygenation for Bridging Right Ventricular Heart Failure to Lung Transplantation: A Single-Center Case Series and Literature Review
Jae Guk Lee, Chuiyong Pak, Dong Kyu Oh, Ho Cheol Kim, Pil-Je Kang, Geun Dong Lee, Se Hoon Choi, Sung-Ho Jung, Sang-Bum Hong
Journal of Cardiothoracic and Vascular Anesthesia.2022; 36(6): 1686. CrossRef
Advanced Circulatory Support and Lung Transplantation in Pulmonary Hypertension
Marie M. Budev, James J. Yun
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Heather Torbic, Benjamin Hohlfelder, Sudhir Krishnan, Adriano R. Tonelli
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Varunsiri Atti, Mahesh Anantha Narayanan, Brijesh Patel, Sudarshan Balla, Aleem Siddique, Scott Lundgren, Poonam Velagapudi
Heart International.2022; 16(1): 37. CrossRef
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Kelly M. Ivins-O’Keefe, Michael S. Cahill, Arthur R. Mielke, Michal J. Sobieszczyk, Valerie G. Sams, Phillip E. Mason, Matthew D. Read
ASAIO Journal.2022; 68(12): 1483. CrossRef
The ProtekDuo for percutaneous V-P and V-VP ECMO in patients with COVID-19 ARDS
Ahmed M El Banayosy, Aly El Banayosy, Joseph M Brewer, Mircea R Mihu, Jaclyn M Chidester, Laura V Swant, Robert S Schoaps, Ammar Sharif, Marc O Maybauer
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Christopher J. Mullin, Corey E. Ventetuolo
Clinics in Chest Medicine.2021; 42(1): 155. CrossRef
Successful Lung Transplantation After 213 Days of Extracorporeal Life Support: Role of Oxygenator-Right Ventricular Assist Device
Jae Kyeom Sim, Kyeongman Jeon, Gee Young Suh, Suryeun Chung, Yang Hyun Cho
ASAIO Journal.2021; 67(7): e127. CrossRef
Oxy-right Ventricular Assist Device for Bridging of Right Heart Failure to Lung Transplantation
Sung Kwang Lee, Do Hyung Kim, Woo Hyun Cho, Hye Ju Yeo
Transplantation.2021; 105(7): 1610. CrossRef
Interventional and Surgical Treatments for Pulmonary Arterial Hypertension
Tomasz Stącel, Magdalena Latos, Maciej Urlik, Mirosław Nęcki, Remigiusz Antończyk, Tomasz Hrapkowicz, Marcin Kurzyna, Marek Ochman
Journal of Clinical Medicine.2021; 10(15): 3326. CrossRef
Intraoperative Management of Adult Patients on Extracorporeal Membrane Oxygenation: an Expert Consensus Statement From the Society of Cardiovascular Anesthesiologists—Part I, Technical Aspects of Extracorporeal Membrane Oxygenation
Michael A. Mazzeffi, Vidya K. Rao, Jeffrey Dodd-o, Jose Mauricio Del Rio, Antonio Hernandez, Mabel Chung, Amit Bardia, Rebecca M. Bauer, Joseph S. Meltzer, Sree Satyapriya, Raymond Rector, James G. Ramsay, Jacob Gutsche
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Intraoperative Management of Adult Patients on Extracorporeal Membrane Oxygenation: An Expert Consensus Statement From the Society of Cardiovascular Anesthesiologists—Part I, Technical Aspects of Extracorporeal Membrane Oxygenation
Michael A. Mazzeffi, Vidya K. Rao, Jeffrey Dodd-o, Jose Mauricio Del Rio, Antonio Hernandez, Mabel Chung, Amit Bardia, Rebecca M. Bauer, Joseph S. Meltzer, Sree Satyapriya, Raymond Rector, James G. Ramsay, Jacob Gutsche
Anesthesia & Analgesia.2021;[Epub] CrossRef

Cardiology/Pulmonary
Successful Rescue Therapy with Pumpless Extracorporeal Carbon Dioxide Removal in a Patient with Persistent Air Leakage due to Empyema: Jaeyoung Cho, Yeon Joo Lee, Jae-Ho Lee, Choon-Taek Lee, Young-Jae Cho; Korean J Crit Care Med. 2017;32(3):284-290. Published online November 14, 2016; DOI: https://doi.org/10.4266/kjccm.2016.00185

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Abstract PDF: A young metastatic lung cancer patient developed empyema due to an infection with carbapenem-resistant Acinetobacter baumannii. Hydropneumothorax was detected and managed by a tube thoracotomy. However, persistent air leakage through the chest tube was observed due to the presence of a bronchopleural fistula (BPF). As hypercapnic respiratory failure had progressed and the large air leak did not diminish by conservative management, a pumpless extracorporeal lung assist (pECLA) device was inserted. The pECLA allowed the patient to be weaned from mechanical ventilation and the BPF to heal. The present case shows the effective application of pECLA in a patient with empyema complicated with BPF and severe hypercapnic respiratory failure. pECLA enabled us to minimize airway pressure to aid in the closure of the BPF in the mechanically ventilated patient.

Pulmonary
Acute Respiratory Failure due to Alveolar Hemorrhage after Exposure to Organic Dust: Sun Mi Choi, Jiwon Koh, Sang-Min Lee, Jinwoo Lee; Korean J Crit Care Med. 2016;31(2):173-177. Published online May 31, 2016; DOI: https://doi.org/10.4266/kjccm.2016.31.2.173

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Abstract PDF: Diffuse alveolar hemorrhage (DAH) is associated with severe outcomes. We report a case of acute respiratory failure that required mechanical ventilation and was clinically and pathologically diagnosed as DAH related to exposure to organic dust. A 39-year-old man, who had visited a warehouse to grade beans for purchase, was referred to our hospital for impending respiratory failure. His initial radiographic examinations revealed diffuse bilateral ground-glass opacities in his lungs and bronchoalveolar lavage resulted in progressively bloodier returns, which is characteristic of DAH. He underwent bedside open lung biopsy of his right lower lobe in the intensive care unit. Biopsy results revealed DAH and organization with accumulation of hemosiderin-laden macrophages and a few fibroblastic foci. The patient was treated with empirical antibiotics and high-dose corticosteroids and successfully weaned from mechanical ventilation. DAH might be considered in the differential diagnosis of patients with acute respiratory failure after exposure to organic particles.

Cardiology/Pulmonary
One Hundred Seven Days of ECMO as a Bridge to Lung Transplantation: The Longest Duration Among Elderly Patients: Eun Jung Kim, Hyo Chae Paik, Moo Suk Park, Myung Hwa Kim, Shin Ok Koh, You Jin Lee, Sungwon Na; Korean J Crit Care Med. 2014;29(1):48-51. Published online February 28, 2014; DOI: https://doi.org/10.4266/kjccm.2014.29.1.48

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Abstract PDF

Extracorporeal membrane oxygenation (ECMO) is a means for supporting adequate gas exchange in patients with severe respiratory failure and is the only therapeutic option for ventilation-refractory patients awaiting lung transplantation. Moreover, defining the patients likely to benefit from ECMO as a bridge to transplantation has recently become a point of interest. Here, we report a case of prolonged ECMO support to a patient awaiting lung transplantation. A 66-year-old woman was diagnosed with acute interstitial pneumonia and was placed on veno-venous (VV) ECMO due to unsatisfactory gas exchange despite maximal ventilator care. She underwent bilateral lung transplantation after 99 days of ECMO and was successfully weaned from it on the 107th ECMO day. This is the longest period of ECMO support to be reported among elderly patients.

Citations

Citations to this article as recorded by

Long-Term Venovenous Connection for Extracorporeal Carbon Dioxide Removal (ECCO2R)–Numerical Investigation of the Connection to the Common Iliac Veins
N. B. Steuer, K. Hugenroth, T. Beck, J. Spillner, R. Kopp, S. Reinartz, T. Schmitz-Rode, U. Steinseifer, G. Wagner, J. Arens
Cardiovascular Engineering and Technology.2020; 11(4): 362. CrossRef
One hundred forty six days on extracorporeal membrane oxygenation (ECMO): Our longest ECMO run
Ahmad Said Abdalmohsen Ali, Mohamed Yosri, Mohamed Abouelwafa, Mahmoud Saad, Kareem Zaki, Shady Mashhour, Husam Salah, Tarek Mohsen, Amaany Abozeid, Mohamed Khaled, Akram Abdelbary, Alia Abdelfattah
The Egyptian Journal of Critical Care Medicine.2018; 6(3): 113. CrossRef
Recovery from Acute Respiratory Distress Syndrome with Long-Run Extracorporeal Membrane Oxygenation
Jin Jeon, Jin Won Huh, Chae-Man Lim, Younsuck Koh, Sang-Bum Hong
Korean Journal of Critical Care Medicine.2014; 29(3): 212. CrossRef

A Case of Pumpless Extracorporeal Interventional Lung Assist for Severe Respiratory Failure: A Case Report: Young Jae Cho, Ji Yeon Seo, Yu Jung Kim, Jae Ho Lee, Choon Taek Lee; Korean J Crit Care Med. 2012;27(2):120-125.; DOI: https://doi.org/10.4266/kjccm.2012.27.2.120

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Abstract PDF: Pumpless extracorporeal interventional lung assist (iLA) is a promising respiratory rescue system permitting protective lung ventilation for severe respiratory failure. Herein, we report a case of prolonged iLA support with regards to a patient exhibiting severe hypercapnic respiratory failure. A 51-year-old female patient with metastatic endometrial carcinoma developed progressive hospital-acquired pneumonia and was intubated in order to restore respiratory failure. Despite maximal mechanical ventilator care, her clinical condition deteriorated due to severe respiratory acidosis. The iLA was performed for the management of refractory hypercapnia. The total duration of iLA support was 23 days without any vascular complications, however, she could not survive because of oxygenation failure.

Original Article

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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Abstract PDF

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.

Citations

Citations to this article as recorded by

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

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