| Japanese |
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| Title | 胸腔内ドレーンによる重症不整脈の一例 |
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| Subtitle | 症例 |
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| Authors | 小林健一*, 劒物修**, 村上雅子**, 上条輝行*, 小林明芳***, 相馬一亥*** |
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| Authors(kana) | |
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| Organization | *北里大学医学部泌尿器科, **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 | 3 |
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| Page | 519-523 |
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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 | 「要旨」高血圧症と腎不全のある73歳の女性で, 泌尿器科手術後ICUにおいて重症の心室性不整脈を経験した. この不整脈は, 多源性心室性期外収縮, short-run, 心室性頻脈を伴うものであり, lidocaine, β-blockerの使用に反応を示さなかった. 高齢者であること, 高血圧症を有することから急性心不全も考え, ジギタリスも使用されたが効果は認められなかった. 術後左胸水貯留に伴う呼吸不全があったために左胸腔ドレナージが施行されていた. 胸部X線写真の再検討でドレーンの位置が心臓に近いことから, 機械的刺激によるものと考え, ドレーンを引き抜いたところ, 30分後に洞調律に復した. 文献上あまり報告をみない貴重な症例と考え報告した. 「はじめに」麻酔中, 麻酔後における患者管理において種々の不整脈をみることはまれではない1〜3). 最近, 私どもは, 術後の呼吸管理の目的でICUに収容された高齢患者で, 種々の抗不整脈薬により改善されなかった重症の心室性不整脈を経験したので報告する. |
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| Practice | 基礎医学・関連科学 |
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| Keywords | |
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| English |
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| Title | Life-threatening arrhythmias caused by an inappropriateiy placed chest tuhe |
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| Subtitle | |
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| Authors | Kenichi Kobayashi*, Osamu Kemmotsu**, Masako Murakami**, Teruyuki Kamijo*, Akiyoshi Kobayashi***, Kazui Soma*** |
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| Authors(kana) | |
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| Organization | *Department of Urology, Kitasato University School of Medicine, **Department of Anesthesiology, Kitasato University School of Medicine, ***Department of Internal Medicine, Kitasato University School of Medicine |
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| Journal | Circulation Control |
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| Volume | 4 |
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| Number | 3 |
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| Page | 519-523 |
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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 | Severe ventricular arrhythmias consisted of mnltifocal ventricular premature contractions, short-run and ventricular tachycardia were observed in a 73 year-old female following administration in the intensive care unit postoperatively. Neither antiarrhythmic drugs such as lidocaine and propranolol nor digitalis improved the arrhythmias at all. After struggling for several hours to treat the condition, we noticed that a chest tube, inserted for pleural effusion of unknoun cause post-operatively in the anesthesia recovery room, was placed very close to the heart by a post-operative chest x-ray film. The tube was immediately taken out and arrlhythmias were gradually improved. One hour later her ECG returned to completely normal state. This corfirmed that the severe ventnicular arrhythmias were due to direct mechanical irritation to the pericardium by an incorrectly placed chest tube. Our case suggests the possibility of ventricular arrlythmias by a chest tube inserted perioperatively and necessity of reevaluation of the tube position by a chest x-ray film, especially in cases that post-operative cardiac arrhythmias show resistance to pharmacological treatment. |
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| Practice | Basic medicine |
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| Keywords | ventricular arrhythmias, chest tube, antiarrhythmic drugs, post-operative patient, intensive care unit |
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