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pulmonary complications of anesthesia

Angela Roberts Selzer, Matthew Murrell, Eugene Shostak
PURPOSE OF REVIEW: As the field of interventional pulmonology continues to expand and develop at a rapid pace, anesthesiologists are increasingly called upon to provide well tolerated anesthetic care during these procedures. These patients may not be candidates for surgical treatment and often have multiple comorbidities. It is important for anesthesiologists to familiarize themselves with these procedures and their associated risks and complications. RECENT FINDINGS: The scope of the interventional pulmonologist's practice is varied and includes both diagnostic and therapeutic procedures...
October 25, 2016: Current Opinion in Anaesthesiology
Jeong-Min Hong, Eunsoo Kim, Hae-Kyu Kim, Do-Won Lee, Ji-Seok Baik, Ji-Youn Lee
INTRODUCTION: Interstitial lung disease (ILD), which is the most common form of respiratory involvement of Sjȍgren syndrome (SS), is highly associated with postoperative pulmonary complications after surgery. We report the successful anesthetic management of a cervical cancer patient with SS and ILD under combined spinal-epidural anesthesia (CSE) to avoid postoperative pulmonary complications. CASE DESCRIPTION: A 41-year-old woman with SS complicated by recently progressive ILD was scheduled for an elective radical hysterectomy under the diagnosis of cervical cancer...
2016: SpringerPlus
Helena Logotheti, Chryssa Pourzitaki, Georgia Tsaousi, Zoi Aidoni, Artemis Vekrakou, Amaniti Ekaterini, Konstantinos Gourgoulianis
BACKGROUND: Chronic Obstructive Pulmonary Disease (COPD) has been associated with major perioperative morbidities or mortalities, especially in surgical patients receiving general anesthesia. The severity of the COPD and the degree of bronchial hyperreactivity can determine the perioperative anesthetic risk; therefore they have to be assessed by a thorough preoperative evaluation in order to give the rationale on which to decide for optimum anesthetic management. OBJECTIVE: Aim of the study was to assess the predictive applicability of exhaled Nitric Oxide (NO) in smoking surgical population with COPD, on the basis of morbidity and mortality...
October 19, 2016: Nitric Oxide: Biology and Chemistry
Leng Zhou, Haidan Lan, Qinghua Zhou, Xiao Jun Tang, Daxing Zhu, Jianming Yue, Bin Liu
BACKGROUND: Ulinastatin can prevent the perioperative increase in proinflammatory cytokines for lung resection surgery; however, its impact on early clinical outcomes remains unknown. METHODS: The study enrolled 108 non-small cell lung cancer (NSCLC) patients who were randomly allocated into two groups: ulinastatin (group U) and control (group C). Patients in group U ( n = 52) were continuously intravenously infused with ulinastatin at a rate of 20 000 U/kg/hour for the first hour after anesthesia induction, and then at a rate of 5000 U/kg/hour until the conclusion of surgery...
September 2016: Thoracic Cancer
Chris Durkin, Travis Schisler, Jens Lohser
PURPOSE OF REVIEW: Despite marked improvements in perioperative outcomes, esophagectomy continues to be a high-risk operation associated with significant morbidity and mortality. Progress has been achieved through evidence-based changes in preoperative optimization, intraoperative ventilation strategies, fluid therapy, and analgesia, as well as expedited postoperative recovery pathways. This review will summarize the recent literature on the anesthetic management of patients undergoing esophageal resection...
October 18, 2016: Current Opinion in Anaesthesiology
Dafna Willner, Valeria Spennati, Shelly Stohl, Giulia Tosti, Simone Aloisio, Federico Bilotta
Spine surgery has been growing rapidly as a neurosurgical operation, with an increase of 220% over a 15-year period. Intraoperative blood transfusion is a major outcome determinant of spine procedures. Various approaches, including pharmacologic and nonpharmacologic therapies, have been tested to decrease both intraoperative and postoperative blood loss. The aim of this systematic review is to report clinical evidence on the relationship between intraoperative blood loss (primary outcome) and on transfusion requirements and postoperative complications (secondary outcomes) in patients undergoing spine surgery...
October 3, 2016: Anesthesia and Analgesia
Jeremiah Wasserlauf, Bradley P Knight, Zhi Li, Adin-Cristian Andrei, Rishi Arora, Alexandru B Chicos, Jeffrey J Goldberger, Susan S Kim, Albert C Lin, Nishant Verma, Martha M Bohn, Rod S Passman
BACKGROUND: Cryoballoon ablation (CBA) for paroxysmal atrial fibrillation (pAF) can be performed under general anesthesia (GA) or moderate sedation (MS). Our objective was to compare the effectiveness, safety, procedure duration, and time spent in the electrophysiology (EP) laboratory for CBA performed under GA and MS. METHODS: . Patients undergoing a first CBA for pAF were identified. Patients received either GA administered by an anesthesiologist or MS with midazolam and fentanyl administered by EP laboratory staff...
October 17, 2016: Pacing and Clinical Electrophysiology: PACE
Abigail C Mancuso, Kelsey Lee, Ran Zhang, Elizabeth A Hoover, Colleen Stockdale, Abbey J Hardy-Fairbanks
OBJECTIVES: Safety of outpatient dilation and evacuations with intravenous (iv) sedation without intubation has been demonstrated, but there is a paucity of data on deep iv sedation on an inpatient second trimester surgical termination population. The purpose of this study is to evaluate complications of deep sedation with propofol without the use of intubation during second trimester surgical terminations in an inpatient teaching institution. STUDY DESIGN: A retrospective chart review of all obstetrical and anesthetic data from inpatient dilation and evacuations between gestational ages 15 0/7 and 24 0/7 during the years 2002 to 2015...
October 3, 2016: Contraception
Pengcheng Xie, Zhanfang Li, Zhongyi Tian
OBJECTIVE: Pulmonary dysfunction after laparoscopic surgery is commonly seen in the high-risk group of obese patients. To reduce or avoid this complication caused by an improper combination of mechanical ventilation parameters, we conducted the following trial of 3 factors with 3 levels of mechanical ventilation, aimed to obtain the low airway pressure with good ventilator effects. METHODS: Patients were randomly allocated as a sample of cases according to the "30≤weight/height(2)<40" obesity index...
November 2016: Journal of Clinical Anesthesia
Lillian M Lai, Joseph Y Cheng, Marcus T Alley, Tao Zhang, Michael Lustig, Shreyas S Vasanawala
PURPOSE: To assess the feasibility of ferumoxytol-enhanced anesthesia-free cardiac MRI in neonates and young infants for complex congenital heart disease (CHD). MATERIALS AND METHODS: With Institutional Review Board approval, 21 consecutive neonates and young infants (1 day to 11 weeks old; median age of 3 days) who underwent a rapid two-sequence (MR angiography [MRA] and four-dimensional [4D] flow) MRI protocol with intravenous ferumoxytol without sedation (n = 17) or light sedation (n = 4) at 3 Tesla (T) (except one case at 1...
September 28, 2016: Journal of Magnetic Resonance Imaging: JMRI
Nitish Fokeerah, Xinwei Liu, Yonggang Hao, Lihua Peng
Managing a patient scheduled for bronchoesophageal fistula repair is challenging for the anesthetist. If appropriate ventilation strategy is not employed, serious complications such as hypoxemia, gastric distension, and pulmonary aspiration can occur. We present the case of a 62-year-old man with a bronchoesophageal fistula in the left main stem bronchus requiring the insertion of a Y-shaped tracheobronchial stent through a rigid bronchoscope, under general anesthesia. We successfully managed this intervention and herein report this case to demonstrate the effectiveness of underwater seal gastrostomy tube drainage used in conjunction with high-frequency jet ventilation during bronchoesophageal fistula stenting...
2016: Case Reports in Anesthesiology
Manuel J Richter, Ralf Ewert, Christian Warnke, Henning Gall, Simon Classen, Friedrich Grimminger, Eckhard Mayer, Werner Seeger, Hossein-Ardeschir Ghofrani
BACKGROUND: In patients with severe pulmonary arterial hypertension, subcutaneous or catheter-based intravenous application of prostanoids carries a risk of local side effects or systemic infections, which limits their use and acceptance. Recently, a fully implantable pump for continuous application of intravenous treprostinil was approved in Germany. However, surgery is a major risk for patients with severe pulmonary arterial hypertension. The purpose of this study was to investigate the safety of a fully implantable pump inserted under local or general anesthesia in patients with severe pulmonary hypertension...
September 26, 2016: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
Audrey Monastesse, Francois Girard, Nathalie Massicotte, Carl Chartrand-Lefebvre, Martin Girard
BACKGROUND: Few diagnostic tools are available to anesthesiologists when confronted with intraoperative hypoxemia. Lung ultrasonography is a safe and accurate bedside imaging modality. The aim of this study was to evaluate the feasibility of lung ultrasonography during the perioperative period and assess its ability to detect intraoperative respiratory complications and oxygenation changes resulting from perioperative atelectasis. METHODS: In this prospective observational pilot study, 30 consecutive patients scheduled for laparoscopic surgery were recruited...
September 23, 2016: Anesthesia and Analgesia
Feng Mao, Liang Zhang, Hengle Gu, Hui Zhang, Changxing Lv, Yang Shen-Tu
BACKGROUND: With the extensively application of HRCT (high resolution CT) and the popularization of early lung cancer screening, the proportion of small nodullar lung cancer to be operated increases rapidly. Identifying the focus lesions quickly and accurately in operation has shown to be a challenge. We carried out this research trying to make use of and evaluate a new method that localizaes and extracts small peripheral pulmonary nodules by way of simulating radiaotherapy combining methylene blue staining...
September 20, 2016: Zhongguo Fei Ai za Zhi, Chinese Journal of Lung Cancer
Chukwudi O Chiaghana, Justin M Bremer, Joshua W Sappenfield, Adam L Wendling
OBJECTIVE: Neuraxial hematoma is a rare complication of spinal or epidural anesthesia. However, variable coagulation factor defects are relatively common in patients with Fontan circulation, and may predispose such patients to either increased risk of thrombosis or coagulopathy. These defects may indirectly increase their risk of neuraxial hematoma. CASE REPORT: We report a case of delayed neuraxial hematoma after the start of full-dose anticoagulation for pulmonary embolus on a postpartum patient with Fontan physiology who had continuous spinal anesthesia for cesarean delivery 4 days earlier...
September 22, 2016: Regional Anesthesia and Pain Medicine
Adrian Mahlmann, Norbert Weiss
Patients with aortic diseases have a high rate of cardiac, cerebrovascular, or pulmonary comorbidities. Open surgery or endovascular interventions of the aorta are associated with high perioperative cardiac risk. Simple scoring systems for preoperative risk stratification can be used to identify high-risk patients. In these patients, further diagnostic and therapeutic interventions are required to reduce perioperative morbidity and mortality. In contrast, low-risk patients can be identified, who may proceed to intervention without additional cardiopulmonary diagnostic testing...
September 2016: Best Practice & Research. Clinical Anaesthesiology
Stavros G Memtsoudis, Jashvant Poeran, Crispiana Cozowicz, Nicole Zubizarreta, Umut Ozbek, Madhu Mazumdar
The role of anesthesia techniques on perioperative outcomes on a population level has recently gained widespread interest. Although mainly neuraxial vs general anesthesia has been addressed, population-level data on the impact of peripheral nerve blocks (PNBs) are still lacking. Therefore, we investigated the association between PNB use and outcomes using retrospective data on 1,062,152 recipients of hip and knee arthroplasties (total hip arthroplasty [THA]/total knee arthroplasty [TKA]) from the national Premier Perspective database (2006-2013)...
October 2016: Pain
Young-Chang P Arai, Jun Kawanishi, Yoshikazu Sakakima, Koichi Ohmoto, Akihiro Ito, Yuki Maruyama, Tatsunori Ikemoto
INTRODUCTION: Pulmonary collapse after intubation is common, and it is caused by a variety of factors. CASE PRESENTATION: A 21-year-old man presented at our operation room to undergo an appendectomy. Except for a history of cigarette smoking, his history was negative. Anesthesia was induced with 100% oxygen and sevoflurane, remifentanil infusion, and propofol. Neuromuscular block was obtained with rocuronium. The tip and cuff of a tracheal tube were lubricated with a topical metered-dose of 8% Lidocaine pump spray...
June 2016: Anesthesiology and Pain Medicine
Hüseyin Balkarlı, Mesut Kılıç, İbrahim Öztürk
Percutaneous vertebroplasty is a relatively safe, simple and commonly performed interventional procedure for the management of vertebral compression fractures. However, serious complications are rarely reported in the procedure. Those are pulmonary embolism, severe infection, paraplegia and an occurrence of a new fracture in an adjacent vertebra after vertebroplasty. Acute complications are generally associated with the procedure. We present the case of neuraxial anesthesia, developed after local anesthesia with 8mL of 2% prilocaine, in a 68-year-old woman who underwent percutaneous vertebroplasty after an osteoporotic collapsed fracture in the L1 vertebra due to trauma...
September 13, 2016: Revista Brasileira de Anestesiologia
Stephanie D Grabitz, Hassan N Farhan, Katarina J Ruscic, Fanny P Timm, Christina H Shin, Tharusan Thevathasan, Anne K Staehr-Rye, Tobias Kurth, Matthias Eikermann
OBJECTIVES: Inhalational anesthetics are bronchodilators with immunomodulatory effects. We sought to determine the effect of inhalational anesthetic dose on risk of severe postoperative respiratory complications. DESIGN: Prospective analysis of data on file in surgical cases between January 2007 and December 2015. SETTING: Massachusetts General Hospital (tertiary referral center) and two affiliated community hospitals. PATIENTS: A total of 124,497 adult patients (105,267 in the study cohort and 19,230 in the validation cohort) undergoing noncardiac surgical procedures and requiring general anesthesia with endotracheal intubation...
September 15, 2016: Critical Care Medicine
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