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KMID : 0378619950120010201
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Baptist Hospital Medical Journal
1995 Volume.12 No. 1 p.201 ~ p.206
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Acute Attack of Asthma and Pulmonary Collapse Induced by Tracheal Intubation
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김성원
김재곤/이중석/권병연
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Abstract
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Identification of the presence of chronic obstructive pulmonary disease in the elderly patient who was scheduled for surgery is vitally important. If appropriate therapeutic and preventive measures should not be instituted, tracheal intubation of
the
patient should be associated with a number of complications.
We experienced a case of acute attack of asthma and pulmonary collapse during endotracheal intubation. A 54-year-old male who was scheduled for an emergency of primary corneo-scleral suture have had history of bronchial asthma. On the
preoperative
physical examination, there was no specific finding except expiratory wheezing. After endotracheal intubation with the aid of ketamine 2mg/kg, pancuronium bromide 0.1mg/kg and lidocaine 2mg/kg iv, acute asthmatic attack was appeared. Breathing
sounds on
the both lung filds can not be audible during manual ventilation and SpO2 was dropped to 70% at F1O2 1.0. To relieve asthmatic attack, epinephrine(1 : 1.000) 0.5ml, sc, aminophylline 4mg/kg, iv and methyprednisolone 1mg/kg, iv were injected.
Erosion of
tracheal mucosa, blood clots, and mucous plugs were found by the fibroptic bronchoscopy. After removal of blood clots and mucus, lung compliance and SpO2 were improved. The patient was discharged 7 days later without any complications of
sequelae.
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KEYWORD
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