[Efficacy of active core rewarming using fluid heating system HOTLINE before and during the operation in a patient with for panperitonitis in state of shock and hypothermia].

A 62-year-old man was transported to the emergency room. He was in the state of shock and hypothermia of 34.2 degrees C. Fluid therapy was started using a HOTLINE to raise the body temperature, with vasopressors, vitamin B1 and sodium bicarbonate after checking arterial blood gas. Diagnosis of panperitonitis was made and operation was started immediately. We used HOTLINE before and during the operation. Body temperature returned to normal ranges, and hemodynamic state was stabilized at the end of the operation. After the operation, he received controlled artificial ventilation and nutrition support with intravenous hyperalimentation. Though he was complicated with disseminated intravascular coagulation, he went to general ward 17 days, and was discharged at 47 days after the operation. Sepsis accompanied with hypothermia leads to poor prognosis. We used fluid therapy with rapid-heating, and obtained good outcome. HOTLINE is effective for hypothermia in an emergency patient, because its effect is sure and does not obstruct the examination and management.

[Pulmonary embolism in three surgical patients despite prophylactic measures].

Pulmonary embolism after surgery became a major problem in Japan recently. From the year 2000, we started the prophylaxis against pulmonary embolism in orthopedic or gynecological surgical patients with some risk factors of pulmonary embolism. But we experienced three cases of pulmonary embolism although two of them had received subcutaneous heparin after surgery. We consider that prophylactic measures are recommended for the patient with risk factors of pulmonary embolism. Pulmonary embolism should be considered when surgical patients complain of abnormality such as chest pain.