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A & A Case Reports

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https://www.readbyqxmd.com/read/28632506/adenotonsillectomy-for-the-management-of-pulmonary-hypertension-in-a-patient-with-complex-congenital-heart-disease-a-case-report
#1
Adam C Adler, Yuan-Jiun Nicole Chao
Pulmonary hypertension is a feared complication in congenital heart disease patients. Patients with pulmonary hypertension are at risk for major perioperative cardiopulmonary complications when undergoing any surgical procedure, especially airway and laparoscopic procedures. We present the anesthetic management for a 2-year old with Down syndrome and complex cyanotic congenital heart disease undergoing tonsillectomy and adenoidectomy for severe obstructive sleep apnea.
June 19, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28622152/use-of-transnasal-humidified-rapid-insufflation-ventilatory-exchange-for-emergent-surgical-tracheostomy-a-case-report
#2
Neel Desai, Anna Fowler
Transnasal humidified rapid-insufflation ventilatory exchange (THRIVE) is a novel airway technique that utilizes high-flow humidified nasal oxygen. It can extend apnea time and maintain oxygen saturation. Here we report the use of THRIVE in a 35-year-old man who required emergent surgical tracheostomy for a clinically relevant compromised airway secondary to acute supraglottic and glottic pathology. Intravenous sedation resulted in hypoventilation close to apnea. THRIVE maintained oxygen saturation for 40 minutes until transient desaturation developed after complete airway obstruction...
June 15, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28622151/two-consecutive-preoperative-cardiac-arrests-involving-vancomycin-in-a-patient-presenting-for-hip-disarticulation-a-case-report
#3
Trip Evans, Sephalie Patel
While an abundance of literature exists describing adverse reactions to vancomycin (eg, nausea, vomiting, red man syndrome, acute kidney injury), there is scarce evidence demonstrating vancomycin anaphylactic reactions requiring cardiopulmonary resuscitation. We report a case of a patient who had 2 separate preoperative episodes of cardiac arrest following vancomycin that occurred 4 weeks apart. Both episodes of anaphylaxis required cardiopulmonary resuscitation, which led to a successful patient outcome. We discuss identification and treatment of vancomycin-induced anaphylaxis...
June 15, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28622150/intraoperative-hyperkalemia-and-ventricular-arrhythmia-during-parathyroidectomy-a-case-report
#4
Daniel J Rosenkrans, Lavinia M Kolarczyk
We present a case of acute hyperkalemia and ventricular arrhythmia during parathyroidectomy in a patient with end-stage renal disease. This case highlights the under-recognized alterations in potassium homeostasis associated with parathyroidectomy and underscores the importance of preoperative optimization.
June 15, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28622149/definitive-airway-management-in-the-presence-of-a-laryngeal-tube-supraglottic-airway-there-s-more-than-one-way-to-skin-a-cat
#5
Hilary P Grocott
No abstract text is available yet for this article.
June 15, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28622148/in-response
#6
Abraham H Hulst, Hans J Avis, Markus W Hollmann, Markus F Stevens
No abstract text is available yet for this article.
June 15, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28622147/brachiocephalic-vein-perforation-during-cannulation-of-internal-jugular-vein-a-case-report
#7
Atsushi Kainuma, Keiichi Oshima, Chiho Ota, Yu Okubo, Naoto Fukunaga, Soon Hak Suh
We report a rare complication of right brachiocephalic vein perforation during ultrasound-guided cannulation of the right internal jugular vein (IJV) in a patient with a tortuous common carotid artery (CCA). We suspect that the tortuous CCA displaced the IJV, which caused misplacement of the J-tip guidewire into the subclavian vein. The stiff dilator sheath introduced over the guidewire then perforated the wall of the brachiocephalic vein, causing massive hemothorax. This was diagnosed by videothoracoscopy...
June 15, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28604473/perioperative-anesthetic-management-for-cesarean-delivery-in-a-parturient-with-type-iv-loeys-dietz-syndrome-a-case-report
#8
Ravish Kapoor, David G Mann, Emad B Mossad
Loeys-Dietz syndrome (LDS) is a rare connective tissue disorder predisposing to aortic and arterial aneurysms. Presentations are classified into subtypes based on gene mutations. Pregnancy in patients with LDS is considered very high risk due to the potential for aortic dissection and uterine rupture. We report successful management of an elective cesarean delivery in a 16-year-old patient with LDS type IV using epidural anesthesia. Perioperative considerations and multidisciplinary management specific to taking care of parturients with LDS are discussed...
June 8, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28604472/perioperative-pain-management-of-a-patient-taking-naltrexone-hcl-bupropion-hcl-contrave-a-case-report
#9
Allen Ninh, Sang Kim, Andrew Goldberg
A 42-year-old obese woman (body mass index = 30.2 kg/m) presented for urgent anterior cervical diskectomy and fusion. She had been taking oral naltrexone-bupropion extended-release (Contrave, Orexigen Therapeutics Inc, La Jolla, CA) for the past 6 months and continued using it until 12 hours preoperatively. Despite discontinuation of this medication, and employing an intraoperative and postoperative multimodal analgesia strategy, immediate pain control was inadequately achieved. Patients taking opioid antagonists who present for surgery pose unique challenges to the anesthesiologist and require extensive preoperative interdisciplinary discussions and planning for pain control throughout the perioperative period...
June 8, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28604471/uncommon-events-may-be-more-common-than-you-think
#10
Aaron F Kopman
No abstract text is available yet for this article.
June 8, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28604470/in-response
#11
Laura V Duggan, J Adam Law, Ian R Morris
No abstract text is available yet for this article.
June 8, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28604469/case-report-of-cardiac-arrest-after-succinylcholine-in-a-child-with-muscle-eye-brain-disease
#12
Thomas Hackmann, David L Skidmore, Brian MacManus
Muscle-eye-brain disease is a rare autosomal recessive disorder characterized by congenital muscular dystrophy, ocular abnormalities, and brain malformation. We report an intraoperative hyperkalemic cardiac arrest following the administration of succinylcholine in a child with muscle-eye-brain disease. The disease was diagnosed only after this event. Our experience suggests that preoperative determinations of serum concentrations of lactate and creatine kinase may be useful if clinical signs consistent with myopathy are present...
June 8, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28604468/point-of-care-ultrasonography-to-assess-portal-vein-pulsatility-and-the-effect-of-inhaled-milrinone-and-epoprostenol-in-severe-right-ventricular-failure-a-report-of-2-cases
#13
Jan-Alexis Tremblay, William Beaubien-Souligny, Mahsa Elmi-Sarabi, Georges Desjardins, André Y Denault
This article describes 2 patients with severe acute right ventricular failure causing circulatory shock. Portal vein pulsatility assessed by bedside ultrasonography suggested clinically relevant venous congestion. Management included cardiac preload reduction and combined inhalation of milrinone and epoprostenol to reduce right ventricular afterload. Portal vein ultrasonography may be useful in assessing right ventricular function in the acutely ill patient.
June 8, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28604467/transnasal-humidified-rapid-insufflation-ventilatory-exchange-for-preoxygenation-before-cesarean-delivery-under-general-anesthesia-a-case-report
#14
Maryse Hengen, Rosalie Willemain, Alain Meyer, Bruno Langer, Girish P Joshi, Pierre Diemunsch
Transnasal humidified rapid-insufflation ventilatory exchange has been shown to improve oxygenation and increase apnea time in difficult airway cases. It may also be beneficial in patients vulnerable to rapid desaturation due to limited pulmonary reserve. We report the use of transnasal humidified rapid-insufflation ventilatory exchange for preoxygenation before a cesarean delivery under general anesthesia in a patient with respiratory distress because of pneumonia and heart failure from severe mitral stenosis...
June 8, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28604466/unique-considerations-in-spinal-cord-stimulator-placement-in-pediatrics-a-case-report
#15
Eugene Kim, Giovanni Cucchiaro
Spinal cord stimulation can be a valuable treatment option in the management of neuropathic pain in select pediatric patients. We present a unique case of a 16-year-old girl with Klippel-Trenaunay-Weber syndrome and scoliosis who required the placement of a spinal cord stimulator (SCS) for severe sciatic nerve neuropathic pain after a right above-knee amputation. Several attempts at lead placement were required before successful pain coverage was achieved because of late recognition of significant vertebral body rotation...
June 8, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28604465/brachial-plexus-injury-associated-with-subclavian-vein-cannulation-a-case-report
#16
Ezgi Gozubuyuk, Mehmet I Buget, Turgut Akgul, Demet Altun, Suleyman Kuçukay
We documented brachial plexus injury by electromyography and magnetic resonance imaging secondary to needle sticks for central line insertion. This type of complication is rare in the literature, as few case reports exist. Brachial plexus injury can happen because of anatomic variations. Nevertheless, multiple attempts or introducer needle rotations should be avoided during subclavian vein catheterization. Pain that emerges in the ipsilateral arm after subclavian catheter placement should be taken into serious consideration...
June 8, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28604464/liver-transplantation-in-a-patient-with-antiphospholipid-syndrome-a-case-report
#17
Rachel C Steckelberg, Zarah D Antongiorgi, Randolph H Steadman
Antiphospholipid syndrome (APS) is an acquired thrombophilic disorder characterized by autoantibodies to cell membrane phospholipids. While altered coagulation can complicate end-stage liver disease, there are few reports describing the perioperative management for liver transplantation in recipients with a preexisting hypercoagulable disorder, such as APS. We present a patient with a history of APS, Budd-Chiari syndrome with cirrhosis, hepatopulmonary syndrome, and heparin-induced thrombocytopenia who underwent liver transplantation complicated by hepatic artery thrombosis...
June 8, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28604463/complete-neurologic-recovery-from-extreme-hypoglycemia-secondary-to-cardiogenic-liver-failure-a-case-report
#18
Yafen Liang, Jeremy M Bennett, Douglas B Coursin, Mark J Rice
Cardiogenic shock from acute severe mitral valve regurgitation can cause acute liver failure due to hypoperfusion. Impaired liver glycogenesis can then lead to profound hypoglycemia. The time frame for restoring normoglycemia without neurologic sequelae is not clearly established in humans. Thus, the clinical decision to provide further resuscitation in the setting of extreme hypoglycemia mainly depends on the patient's overall clinical condition, provider opinion, and/or institutional practice. Here, we report a case where the patient made complete neurologic recovery from extreme hypoglycemia (<5 mg/dL by central laboratory testing) secondary to acute cardiogenic shock and liver failure...
June 8, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28604462/anesthetic-management-of-2-pediatric-patients-with-concurrent-diagnoses-of-mitochondrial-disease-and-malignant-hyperthermia-susceptibility-a-case-report
#19
Jonathon H Nelson, Richard F Kaplan
We report the case of 2 pediatric patients with coexisting diagnoses of malignant hyperthermia susceptibility and mitochondrial disease in 2 different surgical settings. Due to the rare occurrence of each disorder, and even more so together, we reviewed evidence-based anesthetic concerns and described our perioperative management, with the goal of aiding future practitioners in safely caring for these patients. Consent was obtained for both patients, as well as IRB approval before publication.
June 8, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28542046/elective-venovenous-extracorporeal-membrane-oxygenation-for-resection-of-endotracheal-tumor-a-case-report
#20
W Jonathan Dunkman, Alina Nicoara, Jacob Schroder, Momen M Wahidi, Aimen El Manafi, Desiree Bonadonna, Coral X Giovacchini, Frederick W Lombard
We present a case in which we electively used venovenous extracorporeal membrane oxygenation (VV-ECMO) to facilitate safe resection of a nearly obstructing airway tumor near the carina in a 37-year-old male. The patient was brought to the operating room and underwent bifemoral cannulation for VV-ECMO under light sedation while maintaining spontaneous ventilation. After VV-ECMO was initiated, general anesthesia was induced, and the tumor was resected via rigid bronchoscopy. After resection, the patient was intubated, weaned from ECMO, decannulated, awoken, extubated, and taken to the postanesthesia care unit for recovery...
May 24, 2017: A & A Case Reports
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