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https://www.readbyqxmd.com/read/28210501/perioperative-concerns-for-profound-metabolic-alkalosis-during-kidney-transplantation-a-case-report
#1
Jung Ju Choi, Yong Beom Kim, Hong Soon Kim, Kyung Cheon Lee, Youn Yi Jo
INTRODUCTION: Profound metabolic alkalosis is an uncommon consideration for the anesthetic management of kidney transplantation. Serum total carbon dioxide content and complex electrolyte abnormalities might be important diagnostic clues for the presence of metabolic alkalosis in the absence of arterial blood gas analysis. CASE PRESENTATION: A 34-year-old female visited Gachon University Gil Medical Center, Incheon, South Korea during year 2015. She experienced aggravated renal function due to chronic hypokalemia and severe hypochloremic metabolic alkalosis, induced by laxative abuse, and underwent ABO incompatible kidney transplantation...
November 2016: Iranian Red Crescent Medical Journal
https://www.readbyqxmd.com/read/28152199/investigation-of-perioperative-and-anesthetic-variables-affecting-short-term-survival-of-horses-with-small-intestinal-strangulating-lesions
#2
Pablo Espinosa, Sarah S Le Jeune, Alessia Cenani, Philip H Kass, Robert J Brosnan
OBJECTIVE: To determine if preoperative and intraoperative physiologic variables, and surgical factors correlate with survival to anesthetic recovery or hospital discharge, repeat celiotomy, and postoperative nasogastric intubation (NGT) in horses undergoing exploratory celiotomy for small intestinal (SI) strangulating lesions. STUDY DESIGN: Retrospective case series. ANIMALS: Horses that had surgical correction of SI strangulating lesions (n = 258)...
February 2, 2017: Veterinary Surgery: VS
https://www.readbyqxmd.com/read/28121832/central-venous-to-arterial-co2-difference-after-cardiac-surgery-in-infants-and-neonates
#3
Leslie A Rhodes, W Clinton Erwin, Santiago Borasino, David C Cleveland, Jeffrey A Alten
OBJECTIVES: Venous to arterial CO2 difference correlates with cardiac output in critically ill adults, but its utility in pediatric patients is unclear. We sought to correlate venous to arterial CO2 difference with other cardiac output surrogates (arteriovenous oxygen saturation difference, central venous oxygen saturation, and lactate) and investigate its capacity to predict poor outcomes associated with low cardiac output (low cardiac output syndrome) in infants after cardiac surgery with cardiopulmonary bypass...
January 24, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28110639/amitraz-poisoning-a-case-report-of-an-unusual-pesticide-poisoning-in-sri-lanka-and-literature-review
#4
H M M T B Herath, S P Pahalagamage, Nilukshana Yogendranathan, M D M S Wijayabandara, Aruna Kulatunga
BACKGROUND: Amitraz is a pesticide used worldwide on animals and in agriculture. It contains triazapentadiene, which is a centrally acting alpha-2 adrenergic agonist. Amitraz poisoning is fairly uncommon in humans and occurs via oral, dermal or inhalational routes. Only a limited number of case reports of human intoxication have been published and most of them are of accidental ingestion by children. CASE PRESENTATION: A twenty-year-old Sri Lankan female presented following self-ingestion of 20 ml of amitraz resulting in 37...
January 23, 2017: BMC Pharmacology & Toxicology
https://www.readbyqxmd.com/read/27919141/-nonischemic-priapism-following-brachytherapy-a-case-report-and-a-review
#5
Jumpei Oshima, Kazutoshi Fujita, Kentaro Kishimoto, Keigo Osuga, Osamu Suzuki, Tetsuji Soda, Yasutomo Nakai, Hiroshi Kiuchi, Tetsuya Takao, Yasushi Miyagawa, Akira Tsujimura, Norio Nonomura
We report a case of nonischemic priapism following brachytherapy. A 63-year-old man presented 22 days after brachytherapy for prostate cancer. He suffered painless sustained incomplete erection for a few days. The patient was diagnosed with nonischemic priapism by cavernosal blood gas analysis. Right internal pudendal arteriography showed blood pooling in the cavernosum caused by arteriovenous fistula. Selective arterial embolization with gelatin sponge particles was performed and detumescence achieved. To our knowledge,this is the first case of high flow priapism caused by brachytherapy for prostate cancer...
November 2016: Hinyokika Kiyo. Acta Urologica Japonica
https://www.readbyqxmd.com/read/27884421/interpreting-the-incremental-cardiopulmonary-exercise-test
#6
REVIEW
Samir Nusair
The incremental cardiopulmonary exercise test (CPET) is an increasingly used diagnostic method that serves to evaluate patients with chief complaint of dyspnea during exercise. Performing maximal symptom-limited CPET can show if the tested subject has a reduced exercise capacity and give clues to the mechanism of such exercise capacity reduction, cardiac, pulmonary, or pulmonary vascular source. In this review, it is suggested that the evaluation of the complex results of CPET should be performed by first determining if myocardial/circulatory insufficiency is present and second if there is gas exchange abnormality...
February 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/27881097/ischaemic-stroke-and-clostridium-septicum-sepsis-and-meningitis-in-a-patient-with-occult-colon-carcinoma-a-case-report-and-review-of-the-literature
#7
REVIEW
Kosmas Macha, Antje Giede-Jeppe, Hannes Lücking, Roland Coras, Hagen B Huttner, Jürgen Held
BACKGROUND: Clostridium septicum is a rare cause of meningitis and brain abscess in children and adults. Gas production by the pathogen can lead to pneumocephalus and the overall mortality rate of Clostridium septicum CNS infection is as high as 74%. The most common entry site of the pathogen is the gastrointestinal tract. CASE PRESENTATION: We describe a 74-year-old man who presented with a left-sided cerebral infarction in the middle cerebral artery territory...
November 24, 2016: BMC Neurology
https://www.readbyqxmd.com/read/27875408/diagnosing-acute-respiratory-distress-syndrome-in-resource-limited-settings-the-kigali-modification-of-the-berlin-definition
#8
Elisabeth D Riviello, Egide Buregeya, Theogene Twagirumugabe
PURPOSE OF REVIEW: The acute respiratory distress syndrome (ARDS) was re-defined by a panel of experts in Berlin in 2012. Although the Berlin criteria improved upon the validity and reliability of the definition, it did not make diagnosis of ARDS in resource limited settings possible. Mechanical ventilation, arterial blood gas measurements, and chest radiographs are not feasible in many regions of the world. In 2014, we proposed and applied the Kigali modification of the Berlin definition in a hospital in Rwanda...
February 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/27858372/severe-respiratory-acidosis-in-status-epilepticus-as-a-possible-etiology-of-sudden-death-in-lesch-nyhan-disease-a-case-report-and-review-of-the-literature
#9
Alison Christy, William Nyhan, Jenny Wilson
INTRODUCTION: Lesch-Nyhan disease (LND) is an X-linked disorder of purine metabolism, associated with self-mutilation, dystonia, and chorea. Seizures are uncommon in LND. Patients with LND are at risk for sudden and unexpected death. The etiology of this is unknown, but appears to occur from a respiratory process. We propose that respiratory failure secondary to subclinical seizure may lead to sudden death in these patients. CASE: We report a case of an 11-year-old boy with LND who had two episodes of nocturnal gasping...
November 18, 2016: JIMD Reports
https://www.readbyqxmd.com/read/27731850/a-critical-review-of-mechanical-ventilation-virtual-simulators-is-it-time-to-use-them
#10
Juliana Arcanjo Lino, Gabriela Carvalho Gomes, Nancy Delma Silva Vega Canjura Sousa, Andrea K Carvalho, Marcelo Emanoel Bezerra Diniz, Antonio Brazil Viana Junior, Marcelo Alcantara Holanda
BACKGROUND: Teaching mechanical ventilation at the bedside with real patients is difficult with many logistic limitations. Mechanical ventilators virtual simulators (MVVS) may have the potential to facilitate mechanical ventilation (MV) training by allowing Web-based virtual simulation. OBJECTIVE: We aimed to identify and describe the current available MVVS, to compare the usability of their interfaces as a teaching tool and to review the literature on validation studies...
June 14, 2016: JMIR Medical Education
https://www.readbyqxmd.com/read/27729704/esmolol-corrects-severe-hypoxemia-in-patients-with-femoro-femoral-venoarterial-extracorporeal-life-support-for-lung-transplantation
#11
Mohamed Ghalayini, Pierre-Yves Brun, Pascal Augustin, Elise Guivarch, Marie Pierre Dilly, Sophie Provenchere, Pierre Mordant, Yves Castier, Philippe Montravers, Dan Longrois
Competitive flows syndrome result in severe regional hypoxemia when the deoxygenated flow from the native left ventricle (LV) competes with oxygenated flow from extracorporeal life support (ECLS) pump with potentially severe consequences for the cerebral and coronary circulations. Fast correction of hypoxemia could be obtained by decreasing native LV flow by infusion of a short-acting beta-blocker (esmolol). Our purpose was to retrospectively review the efficacy of esmolol in this situation and hypothesize on the potential mechanisms of action and the associated risks...
September 2016: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/27635266/fatal-cerebral-air-embolism-a-case-series-and-literature-review
#12
Rashmi Mishra, Pavithra Reddy, Misbahuddin Khaja
Cerebral air embolism (CAE) is an infrequently reported complication of routine medical procedures. We present two cases of CAE. The first patient was a 55-year-old male presenting with vomiting and loss of consciousness one day after his hemodialysis session. Physical exam was significant for hypotension and hypoxia with no focal neurologic deficits. Computed tomography (CT) scan of head showed gas in cerebral venous circulation. The patient did not undergo any procedures prior to presentation, and his last hemodialysis session was uneventful...
2016: Case Reports in Critical Care
https://www.readbyqxmd.com/read/27617753/intractable-bradycardia-associated-with-hyperkalaemia-in-a-patient-with-end-stage-renal-disease-a-case-report-and-review-of-literature
#13
W Hwang, K Lee, J Joo
A 75-year-old male was diagnosed with diabetic foot syndrome and scheduled for amputation of the right second toe under general anaesthesia. He had suffered from Type 2 diabetes mellitus (DM); he had received maintenance haemodialysis (HD) three times a week for end-stage renal disease (ESRD) due to DM. At 30 minutes after induction, the heart rate decreased below 50 beats per minute (bpm); the arterial blood gas analysis (ABGA) showed a potassium concentration of 6.7 mEq/L without any other abnormal findings...
September 18, 2015: West Indian Medical Journal
https://www.readbyqxmd.com/read/27607154/noninvasive-monitoring-of-co2-during-polysomnography-a-review-of-the-recent-literature
#14
Christopher A Gerdung, Adetayo Adeleye, Valerie G Kirk
PURPOSE OF REVIEW: Sleep-related breathing disorders are complex conditions that require the integration of clinical and sleep laboratory findings to support a diagnosis. Analysis of carbon dioxide (CO2) levels during sleep provides important additional information to the clinician that is not obtained from other polysomnographic indices, and that may have a direct impact on both diagnosis and patient mortality. Although arterial blood gas (ABG) is considered the gold standard for assessing PaCO2 levels, there are numerous drawbacks...
November 2016: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/27579200/a-case-of-the-tof-with-apv-complicated-with-polyhydramnios-and-severe-bronchomalacia
#15
Ali Seven, Emine Esin Yalinbas, Rahmi Ozdemir
Absent pulmonary valve syndrome (APVS) is a rare congenital heart disease with severe pulmonary insufficiency, characterized with aneurysmal dilation in the pulmonary artery and one or both of its branches. We presented a rare case with APVS and literature review in this letter. Prenatal USG examination of the fetus at the 26th week of gestation revealed severe polyhydramnios, dilatation at right ventricle, and abnormal appearance of the heart. At the 31st gestational week, the baby was born with cesarean section...
2016: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27569948/four-year-experience-with-extracorporeal-membrane-oxygenation-for-kidney-transplant-patients-with-severe-refractory-cardiopulmonary-insufficiency
#16
J-K Baek, J S Lee, T H Kim, Y H Kim, D J Han, S K Hong
BACKGROUND: Kidney transplant (KT) recipients are vulnerable to infections because of their immunosuppressive treatments, and they occasionally exhibit serious acute cardiopulmonary dysfunction. The purpose of this study was to report the clinical outcomes of using extracorporeal membrane oxygenation (ECMO) in KT recipients and to identify risk factors for ECMO weaning failure. METHODS: We retrospectively reviewed the electronic medical records of KT patients who experienced severe cardiopulmonary dysfunction refractory to conventional therapy and received ECMO at the Asan Medical Center Surgical Intensive Care Unit between December 2010 and December 2014...
July 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27530418/continuous-high-frequency-oscillation-therapy-in-invasively-ventilated-pediatric-subjects-in-the-critical-care-setting
#17
Stephen Morgan, Christoph P Hornik, Niyati Patel, Walter L Williford, David A Turner, Ira M Cheifetz
BACKGROUND: Continuous high-frequency oscillation (CHFO) creates a pressure gradient in the small airways that accelerates expiratory flow. The intended use of CHFO therapy is to facilitate secretion removal and treat atelectasis. Our objective was to assess the feasibility, safety, and efficacy of CHFO in the mechanically ventilated pediatric population. METHODS: After institutional review board approval, we retrospectively reviewed medical records of mechanically ventilated children treated with CHFO (the MetaNeb system) at our institution from July 1, 2007 through August 31, 2012...
November 2016: Respiratory Care
https://www.readbyqxmd.com/read/27528100/sources-of-mortality-on-dialysis-with-an-emphasis-on-microemboli
#18
Bernd G Stegmayr
Patients on chronic hemodialysis have a shortened survival compared to the general population. There are multiple sources of morbidity and mortality unique to the dialysis population that account for this. Reasons include the effects of blood membrane interactions, intradialytic hypotension, myocardial stunning, excessive interdialytic weight gain, high-flow arteriovenous fistulae, and impaired lipid break down by anticoagulation administered during HD. Another risk factor, not well appreciated, is the occurrence of microemboli of air (microbubbles) during HD...
November 2016: Seminars in Dialysis
https://www.readbyqxmd.com/read/27511813/an-evaluation-of-association-between-train-of-four-values-and-gas-exchange-indices-in-moderate-to-severe-acute-respiratory-distress-syndrome
#19
Lara M Groetzinger, Ryan M Rivosecchi, Sandra L Kane-Gill, Michael P Donahoe
BACKGROUND: Acute respiratory distress syndrome (ARDS) is associated with a mortality rate of approximately 40%. Neuromuscular blockade is associated with an improvement in oxygenation and a reduction in mortality in ARDS. OBJECTIVE: The goal of this evaluation was to determine if the depth of paralysis, determined by train-of-four (TOF) monitoring, correlates with gas exchange in moderate to severe ARDS. METHODS: This was a retrospective review of moderate to severe ARDS patients who were prescribed >12 hours of continuous infusion cisatracurium between January 1, 2013, and December 31, 2014, with a PaO2:FiO2 ratio <150 and documented TOF and arterial blood gases...
August 10, 2016: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/27471142/exercise-hypoxaemia-as-a-predictor-of-pulmonary-hypertension-in-copd-patients-without-severe-resting-hypoxaemia
#20
Yoshio Nakahara, Hiroyuki Taniguchi, Tomoki Kimura, Yasuhiro Kondoh, Shinichi Arizono, Koichi Nishimura, Koji Sakamoto, Satoru Ito, Masahiko Ando, Yoshinori Hasegawa
BACKGROUND AND OBJECTIVE: Pulmonary hypertension (PH) in COPD is associated with morbidity and mortality. Previous studies showed a relationship between resting hypoxaemia and PH, but little is known about the relationship between exercise hypoxaemia and PH in COPD without resting hypoxaemia. METHODS: A retrospective observational study of COPD patients without resting hypoxaemia was conducted to evaluate the relationships between exercise hypoxaemia and pulmonary haemodynamics...
January 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
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