title: Anesthetic Management of a Surgical Patient with Chronic Renal Tubular Acidosis Complicated by Subclinical Hypothyroidism.
abstract: A 53-year-old man with chronic renal tubular acidosis and subclinical hypothyroidism underwent lower leg amputation surgery under general anesthesia. Perioperative acid-base management in such patients poses many difficulties because both pathophysiologies have the potential to complicate the interpretation of capnometry and arterial blood gas analysis data; inappropriate correction of chronic metabolic acidosis may lead to postoperative respiratory deterioration. We discuss the management of perioperative acidosis in order to achieve successful weaning from mechanical ventilation and promise a complete recovery from anesthesia.
authors.affiliation: Department of Anesthesiology, National Hospital Organization Tokyo Medical Center, 2-5-1 Higashigaoka, Meguro-ku, Tokyo 152-8902, Japan.
authors.forename: Hiroe
authors.identifier: 0000-0002-8611-5145
authors.initials: H
authors.lastname: Yoshioka
authors.affiliation: Department of Anesthesiology, National Hospital Organization Tokyo Medical Center, 2-5-1 Higashigaoka, Meguro-ku, Tokyo 152-8902, Japan.
authors.forename: Haruyuki
authors.initials: H
authors.lastname: Yamazaki
authors.affiliation: Department of Anesthesiology, National Hospital Organization Tokyo Medical Center, 2-5-1 Higashigaoka, Meguro-ku, Tokyo 152-8902, Japan.
authors.forename: Rie
authors.initials: R
authors.lastname: Yasumura
authors.affiliation: Department of Anesthesiology, National Hospital Organization Tokyo Medical Center, 2-5-1 Higashigaoka, Meguro-ku, Tokyo 152-8902, Japan.
authors.forename: Kosuke
authors.initials: K
authors.lastname: Wada
authors.affiliation: Department of Anesthesiology, National Hospital Organization Tokyo Medical Center, 2-5-1 Higashigaoka, Meguro-ku, Tokyo 152-8902, Japan.
authors.forename: Yoshiro
authors.identifier: 0000-0002-1116-0216
authors.initials: Y
authors.lastname: Kobayashi