Kyobu geka. The Japanese journal of thoracic surgery
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A 78-year-old man who fell from a step ladder was transported to our hospital by ambulance under the diagnosis of multiple rib fractures and right hemothorax. Since he was in shock on arrival, endotracheal intubation and tube thoracotomy were immediately performed. Though 2 liters of blood was evacuated, persistent hemorrhage was observed, requiring continuous rapid infusion and blood transfusion. ⋯ Intrathoracic hematoma was evacuated through the 2nd large chest tube. Chest tubes were removed on the 7th day. He was discharged on the 17th day without any complications.
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A 44-year-old female was presented to our department with a 4-day history of shortness of breath and chest pain. The chest X-ray showed pneumothorax with completely collapsed left lung. Thoracentesis was performed. ⋯ Those patients were treated with supplemental oxygen without endotracheal intubation. Their oxygen saturation stabilized within 12 hours. They were successfully treated with the sole administration of oxygen.
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We reviewed the effect of obesity in the repair of type A acute aortic dissection (AAD). Between January, 2009 and June, 2010, repair of type A AAD was performed in 51 patients. We divided these patients into 2 groups according to body mass index( BMI). ⋯ The incidence of postoperative hypoxemia was greater in group O than that in group N(81.8% versus 53.6 %, p=0.036). The intubation period was longer in group O than that in group N(8.0±7.1 days versus 3.7±3.1 days, p=0.014), and the intensive care unit (ICU) stay was longer in group O than that in group N(13.7±8.8 days versus 9.3±5.9 days, p=0.04). Obesity is thought to be a risk of young-onset of AAD and postoperative hypoxemia, as well as a prolonged intubation period and ICU stay.