| Japanese |
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| Title | Swan-Ganzカテーテルによる肺動脈破裂の1例-肺動脈造影(BOPA)で確認された症例- |
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| Subtitle | 症例 |
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| Authors | 永井一成*, 劒物修*, 黒川信悟**, 相馬一亥**, 重広世紀子** |
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| Organization | *北里大学医学部麻酔科, **北里大学医学部内科 |
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| Journal | 循環制御 |
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| Volume | 4 |
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| Number | 2 |
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| Page | 347-350 |
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| Year/Month | 1983/ |
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| Article | 報告 |
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| Publisher | 日本循環制御研究会 |
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| Abstract | 1970年にSwanらによって発表されたflowdirected balloon-tippedカテーテル(Swan-Ganzカテーテル)は, 現在では, 心循環器系疾患あるいは急性呼吸不全患者における循環系のモニタリングのひとつとして必要不可欠なものとなってきている1, 2). 使用頻度の増加にともない, Swan-Ganzカテーテル(以下S-Gカテーテル)による合併症の報告も増加している. 致死的合併症である肺動脈破裂の報告は欧米でも30例に満たず3〜12, 国内においての報告はみあたらない. 今回, 私どもは, S-Gカテーテルのバルーンを膨らますことにともなった肺動脈破裂がballoon occlusion pulmonary angiography(BOPA)により確定診断された症例を経験したので報告する. 「1. 症例」症例は91歳の女性(身長135cm, 体重28kg)で, 他院にて急性心筋梗塞と診断され, 著明な呼吸困難を主訴として北里大学病院救命救急センターに転送された. 収容時, 苦悶様顔貌, 軽度意識低下, 聴診所見上全肺野に湿性ラ音, 喘鳴を認め, 心電図上ではV1〜V5のST上昇とQSパターンがみられ前壁梗塞と診断された. |
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| Practice | 基礎医学・関連科学 |
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| English |
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| Title | Perforation of the pulmonary artery by a Swan-Ganz catheter : Diagnosed by Balloon Occlusion Pulmonary Angiography (BOPA) |
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| Authors | Kazushige Nagai*, Osamu Kemmotsu*, Shingo Kurokawa**, Kazui Soma**, Yokiko Shigehiro** |
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| Authors(kana) | |
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| Organization | *Department of Anesthesiology, Kitasato University Hospital, **Department of Internal Medicine, Kitasato University Hospital |
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| Journal | Circulation Control |
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| Volume | 4 |
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| Number | 2 |
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| Page | 347-350 |
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| Year/Month | 1983/ |
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| Article | Report |
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| Publisher | Japan Society of Circulation Control |
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| Abstract | The flow directed balloon-tipped catheter has widely been used for patient monitoring in critical care medicine. Although the incidence of the complications related to the catheter is relatively low, more fatal cases, such as peforation of the pulmonary artery, have recently been reported. A case of perforation of the pulmonary artery by a Swan-Ganz catheter was experienced in a 91 year-old female of acute myocardial infarction. Severe cough, hemoptysis and hypoxemia were observed soon after the inflation of the balloon with 1ml of air. Fan-shaped shadow was noted by X-ray of the chest and diagnosis was confirmed by leakage of contrast media from the pulmonary artery utilizing balloon occulusion pulmonary angiography (BOPA). The patient was dramatically improved by CPPV treatment, but died of pulmonary insufficiency and congestive heart failure 14 days after her admission at ICU. It should be emphasized that indication for usage of a Swan-Ganz catheter should be very strict especially in aged patients, balancing merits and demerits of this monitoring devise, and that the appropriate guidelines should be followed to prevent such a fatal complicati on. |
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| Practice | Basic medicine |
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| Keywords | Perforation of the pulmonary artery, Swan-Ganz catheter, balloon occlusion pulmonary angiography |
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