title: [A case of pulmonary edema due to excess absorption of perfusion fluid during transcervical resection using saline solution].
abstract: A 39-year-old woman underwent transcervical resection (TCR) of submucosal uterus myoma. Induction and maintenance of anesthesia were managed with total intravenous anesthesia using propofol, remifentanil and rocuronium bromide. Patient had stable condition from the anesthesia induction until 75 minutes following skin incision. However, around that period, sudden tidal volume reduction, worsening oxygenation, and head and neck swelling developed. Arterial blood gas analysis indicated high-chloride metabolic acidosis. Transesophageal echocardiography showed excess right heart overload. On arriving at ICU, body weight of the patient increased about 10 kg compared to the preoperative value. Artificial ventilation and diuretics administration were done to treat excess body fluid. And the patient recovered without any subsequent complications. It should be noted that in case of TCR, unpredicted excess fluid load could develop, and careful observation and management are required by anesthesiologist in charge.
authors: Department of Anesthesiology, Hirosaki University Hospital, Hirosaki 036-8563.
authors: Norikazu
authors: N
authors: Takada
authors: Ayaka
authors: A
authors: Fujita
authors: Hiroshi
authors: H
authors: Hashimoto
authors: Tetsuya
authors: T
authors: Kushikata
authors: Hironori
authors: H
authors: Ishihara
authors: Kazuyoshi
authors: K
authors: Hirota
mesh_terms: D000042:Absorption; D000328:Adult; D005260:Female; D006801:Humans; D007045:Hysterectomy, Vaginal; D007431:Intraoperative Complications; D007889:Leiomyoma / Q000601:surgery; D010477:Perfusion; D011654:Pulmonary Edema / Q000209:etiology*; D012965:Sodium Chloride / Q000009:adverse effects* / Q000378:metabolism; D014594:Uterine Neoplasms / Q000601:surgery
chemical_list: D012965:Sodium Chloride