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Respiratory Failure during BIS-Guided Sedation in a Patient with Relapsing Polychondritis: A Case Report
Relapsing polychondritis (RP) is a rare autoimmune disorder that causes inflammation and deterioration of cartilaginous structures such as the ears, nose, joints and laryngotracheobronchial tree. A 42-year-old man receiving treatment for RP underwent open reduction and internal fixation of a femur f...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9862252/ https://www.ncbi.nlm.nih.gov/pubmed/36676688 http://dx.doi.org/10.3390/medicina59010065 |
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author | Lee, Jaesang Moon, Hosik Hong, Sungjin Chon, Jinyoung Kwon, Hyejin Park, Hunwoo Lee, Jiyung |
author_facet | Lee, Jaesang Moon, Hosik Hong, Sungjin Chon, Jinyoung Kwon, Hyejin Park, Hunwoo Lee, Jiyung |
author_sort | Lee, Jaesang |
collection | PubMed |
description | Relapsing polychondritis (RP) is a rare autoimmune disorder that causes inflammation and deterioration of cartilaginous structures such as the ears, nose, joints and laryngotracheobronchial tree. A 42-year-old man receiving treatment for RP underwent open reduction and internal fixation of a femur fracture under spinal anesthesia and with sedation by propofol and remifentanil. The level of sedation was monitored via a bispectral index (BIS), and maintained at between 60 and 80. At the end of the operation, he lost consciousness and displayed weak respiratory effort. During mask ventilation, the patient was judged to have respiratory failure due to high end-tidal CO(2) (EtCO(2)) concentration and respiratory acidosis in an arterial-blood-gas analysis (ABGA). Ventilation through a properly inserted laryngeal-mask-airway or endotracheal intubation were impossible; instead, a surgical tracheotomy was performed. After recovering from respiratory failure with ventilatory support in the intensive care unit (ICU), he experienced the same symptoms three more times, requiring ventilatory support. He was discharged with bilevel positive-airway-pressure (BiPAP), after successful adaptation. |
format | Online Article Text |
id | pubmed-9862252 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-98622522023-01-22 Respiratory Failure during BIS-Guided Sedation in a Patient with Relapsing Polychondritis: A Case Report Lee, Jaesang Moon, Hosik Hong, Sungjin Chon, Jinyoung Kwon, Hyejin Park, Hunwoo Lee, Jiyung Medicina (Kaunas) Case Report Relapsing polychondritis (RP) is a rare autoimmune disorder that causes inflammation and deterioration of cartilaginous structures such as the ears, nose, joints and laryngotracheobronchial tree. A 42-year-old man receiving treatment for RP underwent open reduction and internal fixation of a femur fracture under spinal anesthesia and with sedation by propofol and remifentanil. The level of sedation was monitored via a bispectral index (BIS), and maintained at between 60 and 80. At the end of the operation, he lost consciousness and displayed weak respiratory effort. During mask ventilation, the patient was judged to have respiratory failure due to high end-tidal CO(2) (EtCO(2)) concentration and respiratory acidosis in an arterial-blood-gas analysis (ABGA). Ventilation through a properly inserted laryngeal-mask-airway or endotracheal intubation were impossible; instead, a surgical tracheotomy was performed. After recovering from respiratory failure with ventilatory support in the intensive care unit (ICU), he experienced the same symptoms three more times, requiring ventilatory support. He was discharged with bilevel positive-airway-pressure (BiPAP), after successful adaptation. MDPI 2022-12-28 /pmc/articles/PMC9862252/ /pubmed/36676688 http://dx.doi.org/10.3390/medicina59010065 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Case Report Lee, Jaesang Moon, Hosik Hong, Sungjin Chon, Jinyoung Kwon, Hyejin Park, Hunwoo Lee, Jiyung Respiratory Failure during BIS-Guided Sedation in a Patient with Relapsing Polychondritis: A Case Report |
title | Respiratory Failure during BIS-Guided Sedation in a Patient with Relapsing Polychondritis: A Case Report |
title_full | Respiratory Failure during BIS-Guided Sedation in a Patient with Relapsing Polychondritis: A Case Report |
title_fullStr | Respiratory Failure during BIS-Guided Sedation in a Patient with Relapsing Polychondritis: A Case Report |
title_full_unstemmed | Respiratory Failure during BIS-Guided Sedation in a Patient with Relapsing Polychondritis: A Case Report |
title_short | Respiratory Failure during BIS-Guided Sedation in a Patient with Relapsing Polychondritis: A Case Report |
title_sort | respiratory failure during bis-guided sedation in a patient with relapsing polychondritis: a case report |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9862252/ https://www.ncbi.nlm.nih.gov/pubmed/36676688 http://dx.doi.org/10.3390/medicina59010065 |
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