Safety Notes

General Information
19
en
WARNING!
Idiosyncratic reactions
In rare cases, idiosyncratic reactions such as
intravascular coagulopathy
allergic reaction including anaphylaxis
may occur during a surgical procedure if a liquid distention medium is used.
WARNING!
Pulmonary edema
A surgical procedure has the risk of pulmonary edema, which is formed due a
"fluid overload" with isotonic fluids. It is critical to closely monitor the input and
outflow of the distending liquid at all times.
WARNING!
Cerebral edema
A surgical procedure has the risk of cerebral edema resulting from fluid overload
and electrolyte disturbances with hypoosmolar (non-ionic) fluids such as glycine
1.5 % and sorbitol 3.0 %. It is critical to closely monitor the input and outflow of
the distending liquid at all times.
WARNING!
Fluid intake and output surveillance
Strict fluid intake and output surveillance should be maintained. If a low viscos-
ity liquid is used, a transurethral instillation exceeding 2 liters must be moni-
tored with great care due to the possibility of fluid overload.
WARNING!
Hyponatremia
Some distension fluids may lead to fluid overload and, consequently, hyponatre-
mia with its attending sequelae. This can be affected by the distending pressure,
flow rate, and duration of hysteroscopic procedure. It is critical to closely moni-
tor the input and outflow of the distending liquid at all times.
WARNING!
Fluid Overload
There is a risk of irrigation fluid reaching the circulatory system of the patient's
soft tissue. This can be affected by distention pressure, flow rate, perforation of
the distended body cavity and duration of the endoscopic surgery. It is critical to
closely monitor the input and outflow of the distending liquid at all times.
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