Σάββατο 2 Νοεμβρίου 2019

Andexanet Alfa Use in Patients Requiring Cardiopulmonary Bypass: Quo Vadis?
No abstract available
The Use of Liposomal Bupivacaine in Erector Spinae Plane Block to Minimize Opioid Consumption for Breast Surgery: A Case Report: Erratum
No abstract available
Bradycardic Arrest During Somatosensory-Evoked Potential Monitoring: A Case Report
Intraoperative neurophysiological monitoring involves electrical stimulation of nerve pathways and is used to assess the integrity of both motor and sensory pathways. Whereas motor pathway monitoring involves transcranial stimulation and peripheral nerve monitoring, somatosensory monitoring involves peripheral nerve stimulation and cranial monitoring. Arrhythmias are a known complication of motor-evoked potential monitoring but have not been reported with somatosensory monitoring. We describe a case of bradycardic arrest with somatosensory-evoked potential monitoring using median nerve electrodes in a patient with no previous rhythm abnormality. Clinicians caring for patients receiving somatosensory monitoring should be aware of the potential for severe arrhythmias. Accepted for publication September 23, 2019. Funding: This study was supported by the Department of Anesthesia and Critical Care at the University of Chicago. Conflicts of Interest: See Disclosures at the end of the article. Address correspondence to Jacqueline Morano, MD, Department of Anesthesia and Critical Care, University of Chicago, 5841 S Maryland Ave, MC 4028, Chicago, IL 60637. Address e-mail to jmorano1@dacc.uchicago.edu. © 2019 International Anesthesia Research Society
Subdural Displacement of an Epidural Catheter With Spinal Cord Compression in a Patient With Chronic Cancer Pain: A Case Report
Here we present the case of a 76-year-old woman with pancreatic cancer receiving epidural analgesia for chronic cancer pain treatment. Attempts of running the epidural catheter sequentially resulted in unexpected and extensive sensory block together with sympathicolysis but insufficient pain control. Finally, after 3 failed attempts of epidural catheter placements with insufficient pain control and uncommon neurological signs, a magnetic resonance imaging (MRI) scan of the spine was ordered. The MRI showed subdural catheter displacement with extensive liquid accumulation in the subdural space and consequent significant spinal cord compression. Findings normalized after removing the subdural catheter. Accepted for publication September 23, 2019. Funding: None. The authors declare no conflicts of interest. Address correspondence to Michael T. Ganter, MD, Institute of Anesthesiology, Brauerstrasse 15, 8401 Winterthur, Switzerland. Address e-mail to michael.ganter@ksw.ch. © 2019 International Anesthesia Research Society
Echocardiographic Assessment of Ventricular Septal Defects
No abstract available
Real-Time 3-Dimensional Transesophageal Echocardiography Imaging–Guided Percutaneous Closure of Left Ventricular to Left Atrial Fistula
No abstract available
A High Doppler Gradient: Obstruction or No Obstruction?: A Case Report
The angle correction feature in ultrasound systems is used when there is difficulty accurately aligning the Doppler beam with the flow to be interrogated. The operator can manually “correct” the angle to the actual direction of flow. Subsequently, the machine corrects the peak velocity for the angle. We present a case of aortic valve replacement (AVR) in which falsely high transaortic gradients were obtained immediately after separation from cardiopulmonary bypass (CPB). We recommend that there be a more prominent notification when the angle correction feature is used with machine prompts confirming when a peak velocity is obtained using angle correction. Accepted for publication September 13, 2019. Funding: None. The authors declare no conflicts of interest. Address correspondence to Feroze Mahmood, MD, Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02215. Address e-mail to fmahmood@bidmc.harvard.edu. © 2019 International Anesthesia Research Society
Anesthetic Management During Pediatric Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy With Cisplatin in a Small Child: A Case Report and Systematic Literature Review
Cytoreductive surgery (CS) and hyperthermic intraperitoneal chemotherapy (HIPEC) present a challenging task for anesthesia providers. Anesthesia management may be complicated by hyperthermia, fluid shifts, and distinct inflammatory response. Only a few reports dealing with the anesthesia management of pediatric CS and HIPEC have been published. We report a case of a 2-year-old child with a relapse of an alveolar rhabdomyosarcoma of the uterus and peritoneal carcinomatosis treated with CS and HIPEC. For children, careful temperature measurement, intraoperative prevention of hyperthermia, and sufficient volume management are important, as well as postoperative pediatric intensive care with experience CS and HIPEC patients. Accepted for publication September 18, 2019. Funding: None. The authors declare no conflicts of interest. Address correspondence to Thomas S. Zajonz, MD, Department of Anesthesiology and Intensive Care Medicine, University Hospital Giessen and Marburg GmbH, Campus Giessen Rudolf-Buchheim-Str. 7, 35392 Giessen, Germany. Address e-mail to thomaszajonz@chiru.med.uni-giessen.de. © 2019 International Anesthesia Research Society
Point-of-Care Thromboelastography for Intrathecal Drain Management in Patients With Coagulopathy and Thoracic Aorta Surgery: A Case Report
Spinal drain placement to prevent spinal cord ischemia during thoracic aorta surgery is a necessary yet complex undertaking in patients with coagulopathies. Thromboelastography (TEG) can be used as a point-of-care management tool to monitor coagulation status before drain placement and removal. We present 2 cases: a case of a patient with factor VII deficiency and a case of a patient with thrombocytopenia for whom TEG was an important procedural adjunct during coagulopathy reversal. TEG parameters are also discussed to encourage more frequent TEG use as an adjunct during these complex cases. Accepted for publication September 23, 2019. Funding: None. The authors declare no conflicts of interest. Address correspondence to Robina Matyal, MD, Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02215. Address e-mail to rmatyal1@bidmc.harvard.edu. © 2019 International Anesthesia Research Society
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