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Prevention of aspiration of gastric contents during attempt in tracheal intubation in the semi-lateral and lateral positions

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World Journal of Emergency Medicine 2016年第4期7卷 285-289页

作者： Ichiro Takenaka kazuyoshi aoyama Department of Anesthesia Kyushu Rosai Hospital Department of Anesthesia Kitakyushu General Hospital

BACKGROUND:Pulmonary aspiration of gastric contents during tracheal intubation is a lifethreatening complication in emergency *** sequence intubation is commonly performed to prevent aspiration but is not associated with low risk of intubation related *** it has been considered that aspiration can be prevented in the lateral position,few studies have evaluated the ability to prevent ***,this position is not always a favorable position for tracheal *** aspiration can be prevented in a clinically relevant semi-lateral position,it may be *** assessed the ability to prevent aspiration in the lateral position and various degrees of the semi-lateral position using a vomiting-regurgitation manikin ***:A manikin's head was placed in the neutral,simple extension,or sniffing *** amount of aspirated saline into the bronchi during simulated vomiting was measured at semilateral position angles of 0°to 90° in 10° *** difference in the vertical height between the mouth corner and the inferior border of the vocal cord was measured radiologically at each semilateral position in the three head-neck ***:Pulmonary aspiration was prevented at the ≥70°,≥80°,and 90° semi-lateral positions in the neutral,simple extension,and sniffing positions,*** mouth was lower than the vocal cord in the semi-lateral position in which aspiration was ***:The lateral or excessive semi-lateral position was necessary to protect the lung from aspiration in the head-neck positions commonly used for tracheal *** of aspiration was difficult within clinically relevant semi-lateral positions.

关键词： Pulmonary aspiration Lateral position Semi-lateral position

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Impact of continuous local lavage on pancreatic juice-related postoperative complications: Three case reports

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World Journal of Clinical Cases 2019年第17期7卷 2526-2535页

作者： Tomohide Hori Kohei Ogawa Hidekazu Yamamoto Hideki Harada kazuyoshi Matsumura Michihiro Yamamoto Masahiro Yamada Takefumi Yazawa Katsutoshi Kuriyama Masaki Tani Daiki Yasukawa Yasuyuki Kamada Yuki Aisu Ryotaro Tani Ryuhei aoyama Shinnosuke Nakayama Yudai Sasaki Koki Nishimoto Masazumi Zaima Department of Surgery Shiga General HospitalMoriyama 524-8524Japan Department of Hepatobiliary Pancreatic and Breast Surgery Ehime UniversityToon 791-0295Japan Department of Gastroenterology and Hepatology Shiga General HospitalMoriyama 524- 8524Japan Department of Surgery Shiga University of Medical ScienceOtsu 520-2192Japan Department of Surgery Kyoto University Graduate School of MedicineKyoto 606- 8507Japan

BACKGROUND Postoperative pancreatic leakage readily results in intractable pancreatic fistula and subsequent intraperitoneal *** refractory complication can be fatal;therefore,intensive treatment is *** local lavage (CLL) has recently been reevaluated as effective treatment for severe infected pancreatitis,and we report three patients with postoperative intractable pancreatic fistula successfully treated by *** also discuss our institutional protocol for CLL for postoperative pancreatic *** SUMMARY The first patient underwent subtotal stomach-preserving pancreaticoduodenectomy,and pancreatic leakage was observed *** pancreatic fistula led to intraperitoneal abscess,and CLL near the pancreaticojejunostomy site was instituted from postoperative day (POD) *** abscess resolved after 7 d of *** second patient underwent distal *** leakage was observed,and intractable pancreatic fistula led to intraperitoneal abscess near the pancreatic *** was instituted from POD 9,and the abscess resolved after 4 d of *** third patient underwent aneurysmectomy and splenectomy with wide exposure of the pancreatic *** retrograde pancreatic drainage was performed on POD 15 to treat pancreatic fistula;however,intraperitoneal abscess was detected on POD *** performed CLL endoscopically via the transgastric route because the percutaneous approach was *** was instituted from POD 63,and the abscess resolved after 1 wk of *** CLL has therapeutic potential for postoperative pancreatic fistula.

关键词： Surgery Pancreas Pancreatic fistula Pancreatic juice Postoperative complications Case report

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