Anesthetic management of a patient with mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS) during laparotomy
Anesthetic management of a patient with mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS) during laparotomy
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DOI：
10.1007/s00540-006-0449-y
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发表时间：
2007-01-01
影响因子：
2.8
通讯作者：
Katsuya, Hirotada
中科院分区：
文献类型：
--
作者：
Sasano, Nobuko;Fujita, Yoshihito;Katsuya, Hirotada
一名 53 岁男性，患有线粒体肌病、脑病。乳酸性酸中毒和中风样发作（MELAS）接受了胃切除术。我们给予碳酸氢林格氏溶液，其具有生理浓度的碳酸氢盐。术中及术后3h内血清乳酸水平未明显升高，未发生代谢性酸中毒。为了维持正常体温，需要积极加温，这可能是因为 MELAS 患者负责产热的线粒体呼吸链受损。为了避免进一步的线粒体代谢抑制，维持 MELAS 患者的正常体温非常重要。
A 53-year-old man with mitochondrial myopathy, encephalopathy. lactic acidosis, and stroke-like episodes (MELAS) underwent a gastrectomy. We administered bicarbonated Ringer's solution, which has a physiological concentration of bicarbonate. The level of serum lactate did not increase significantly, and metabolic acidosis did not occur throughout surgery or for 3h after surgery. Aggressive warming was needed to maintain normothermia, presumably because the mitochondrial respiratory chain, which is responsible for thermogenesis, is impaired in MELAS patients. It is important to maintain normothermia in MELAS patients in order to avoid further mitochondrial metabolic depression.