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만성 양측성 성대마비 환자에서 기관절개술 후 발생한 이산화탄소 혼수 1예

A Case of Carbon Dioxide Narcosis Following Tracheotomy in Chronic Bilateral Vocal Cord Paralysis Patient

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주제분류이비인후과학

초록

Failure of pulmonary ventilation capacity results in carbon dioxide (CO2) retention. When this produces loss of consciousness, it is called CO2 narcosis. Chronic obstructive pulmonary disease is a common cause of CO2 retention. Bilateral vocal cord paralysis is a typical disorder resulting in upper airway obstruction. However, bilateral vocal cord paralysis has been rarely documented in the chronic course of obstructive diseases related to the ear/nose/throat because its symptoms are relatively obvious. A 49-year-old man who complained of hoarseness and dyspnea for several years was diagnosed with bilateral vocal cord paralysis. CO2 narcosis occurred after tracheostomy and laser posterior cordotomy had been applied to relieve dyspnea. Details of the case are provided along with a review of the relevant literature.

Abstract

Failure of pulmonary ventilation capacity results in carbon dioxide (CO2) retention. When this produces loss of consciousness, it is called CO2 narcosis. Chronic obstructive pulmonary disease is a common cause of CO2 retention. Bilateral vocal cord paralysis is a typical disorder resulting in upper airway obstruction. However, bilateral vocal cord paralysis has been rarely documented in the chronic course of obstructive diseases related to the ear/nose/throat because its symptoms are relatively obvious. A 49-year-old man who complained of hoarseness and dyspnea for several years was diagnosed with bilateral vocal cord paralysis. CO2 narcosis occurred after tracheostomy and laser posterior cordotomy had been applied to relieve dyspnea. Details of the case are provided along with a review of the relevant literature.

참고문헌 (13)

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  8. Kanner RE, "Bilateral vocal cord paralysis for 26 years with respiratory failure. Timing of restoration of tidal volume and serum electrolytes after tracheostomy", Chest, 84(3), pp.304~306 (1983)
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  10. Bone RC, "Controlled oxygen administration in acute respiratory failure in chronic obstructive pulmonary disease: a reappraisal", Am J Med, 65(6), pp.896~902 (1978)
  11. Reid KH, "Carbon dioxide narcosis-induced apnea in a rat model of cardiac arrest and resuscitation", Resuscitation, 38(3), pp.185~191 (1998)
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