Journal of anesthesia
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Journal of anesthesia · Apr 2021
Case ReportsPerioperative management of Fontan operation for the child with panhypopituitarism: a case report.
With the surgical improvement of congenital heart disease, Fontan operation has been applied to many complicated patients in recent years. This is the first report of a child with panhypopituitarism who underwent Fontan operation. A 5-year-old boy was scheduled for Fontan operation. ⋯ Although urine output and serum sodium concentration were adequately controlled by adjustment of vasopressin infusion rate during surgery, massive pleural effusions and ascites developed postoperatively, which required several days for control by adjusting the dose of oral DDAVP and normalize the serum sodium level. Intraoperative management of Fontan operation for a patient with panhypopituitarism was controllable by appropriate hormone replacement. However, postoperative fluid management was complicated by the clinical features of panhypopituitarism and Fontan physiology.
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Journal of anesthesia · Apr 2021
The characteristics, types of intervention, and outcomes of postoperative patients who required rapid response system intervention: a nationwide database analysis.
Improving the safety of general wards is a key to reducing serious adverse events in the postoperative period. We investigated the characteristics, treatment, and outcomes of postoperative patients managed by a rapid response system (RRS) in Japan to improve postoperative management. ⋯ Approximately, 70% of the RRS activations occurred within postoperative day 3. Circulatory problems were a more frequent cause of RRS activation in the postoperative group than in the non-postoperative group.
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Journal of anesthesia · Apr 2021
Observational StudyClinical characteristics and outcomes of critically ill patients with COVID-19 in Kobe, Japan: a single-center, retrospective, observational study.
Coronavirus disease 2019 (COVID-19) has placed a great burden on critical care services worldwide. Data regarding critically ill COVID-19 patients and their demand of critical care services outside of initial COVID-19 epicenters are lacking. This study described clinical characteristics and outcomes of critically ill COVID-19 patients and the capacity of a COVID-19-dedicated intensive care unit (ICU) in Kobe, Japan. ⋯ During the first months of the outbreak in Kobe, most critically ill patients were men aged ≥ 60 years with at least one comorbidity and on mechanical ventilation; the ICU capacity was not strained, and the case-fatality rate was 19%.
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Journal of anesthesia · Apr 2021
Incidence of accidental events during anesthesia from 2012 to 2016: survey on anesthesia-related events by the Japanese Society of Anesthesiologists.
The Japanese Society of Anesthesiologists (JSA) has conducted surveys on life-threatening accidental events during anesthesia and reported results since 1992. This report describes the incidence of these life-threatening accidental events in the survey period between 2012 and 2016. ⋯ The incidence of cardiac arrest during this period was 2.63/10,000, which was lower the incidence reported in other countries. While no change was observed in the incidence of severe hypotension over the survey period, the incidence of severe hypoxia and life-threatening arrhythmia decreased by 20-25% during those 5 years.
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Journal of anesthesia · Apr 2021
Ethnic disparities in postpartum hemorrhage after cesarean delivery: a retrospective case-control study.
To explore the relationship of ethnicity and postpartum hemorrhage (PPH) for women who underwent cesarean delivery (CD) and examine the risk factors for PPH in distinct ethnic groups in China. ⋯ Uygur have more tendency to PPH compared to Han, and risk factors for PPH in Uygur and Han groups may differ. Knowing these differences may be meaningful when planning interventions and resources for high-risk patients undergoing cesarean delivery, and we need more research aimed at risk factors for PPH.