title: [Perioperative management of total laryngectomy for a patient with cold agglutinin disease].
abstract: Cold agglutinin disease is possible to cause thromboembolism of various organs due to changes in red blood cells by exposure to low temperature. Safety standards for perioperative management of patients with cold agglutinin have not been established. A patient with cold agglutinin disease was scheduled to undergo total laryngectomy and greater pectoral muscle flap. We thought it important to perform intensive temperature control to prevent a decrease in temperature below the thermal amplitude, which induces agglutinin in the vessel. We tried to keep the temperature of the patient with the warming equipment aggressively and monitored the shift of temperature in detail. It was also important to shorten the surgery with less hemorrhage and anesthetic management which can avoid a large shift in body temperature. We could keep peripheral and deep temperature above the critical point causing agglomeration. We did not find any symptoms of microembolism due to cold agglutination during the operation.
authors.affiliation: Department of Anesthesiology, Faculty of Medicine, Shimane University, Izumo 693-8501.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Watanabe
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Nikai
authors.forename: Yurika
authors.initials: Y
authors.lastname: Nosaka
authors.forename: Kumiko
authors.initials: K
authors.lastname: Miyake
authors.forename: Yoji
authors.initials: Y
authors.lastname: Saito
mesh_terms: D000744:Anemia, Hemolytic, Autoimmune / Q000150:complications*; D006801:Humans; D007822:Laryngeal Neoplasms / Q000601:surgery; D007825:Laryngectomy; D008297:Male; D008875:Middle Aged; D019990:Perioperative Care