JA Clinical Reports最新文献

Comment on: "Technical considerations in interpreting rapid transfusion through a 4.2-Fr Broviac catheter"-a reply. 评论：“解读4.2 fr Broviac导管快速输血的技术考虑”——回复。

IF 1.2

JA Clinical Reports Pub Date : 2026-10-07 DOI: 10.1186/s40981-026-00881-5

Shoko Fujioka, Yusuke Miyazaki, Hinako Furuya, Chika Miyazaki, Nobuyuki Katori, Yoshie Taniguchi

引用次数: 0

Technical considerations in interpreting rapid transfusion through a 4.2-Fr Broviac catheter. 解释4.2 fr Broviac导管快速输血的技术考虑。

IF 1.2

JA Clinical Reports Pub Date : 2026-10-07 DOI: 10.1186/s40981-026-00878-0

Keiichiro Mizuno

引用次数: 0

Early recognition and safe management of unintentional intrathecal placement of an epidural catheter during combined spinal-epidural labor analgesia: a case report in the context of the 2024 OAA guidelines. 脊髓-硬膜外联合分娩镇痛过程中意外置入硬膜外导管的早期识别和安全处理：2024年OAA指南背景下的一例报告。

IF 1.2

JA Clinical Reports Pub Date : 2026-07-22 DOI: 10.1186/s40981-026-00869-1

Hidenobu Watanabe, Choko Kume, Arisa Ijuin, Yoko Yamashita, Masaki Sato, Reiko Ohara

{"title":"Early recognition and safe management of unintentional intrathecal placement of an epidural catheter during combined spinal-epidural labor analgesia: a case report in the context of the 2024 OAA guidelines.","authors":"Hidenobu Watanabe, Choko Kume, Arisa Ijuin, Yoko Yamashita, Masaki Sato, Reiko Ohara","doi":"10.1186/s40981-026-00869-1","DOIUrl":"10.1186/s40981-026-00869-1","url":null,"abstract":"Background: Unintentional intrathecal catheter placement is a recognized complication of labor neuraxial analgesia. Although continuous spinal analgesia (CSA) may be used as a management option, prompt recognition, careful catheter management, and close monitoring are required to prevent complications such as severe spinal anesthesia.Case presentation: A 31-year-old primigravida underwent combined spinal-epidural analgesia for labor pain. Intrathecal catheter placement was diagnosed after a test dose was administered based on hypotension, motor weakness, sensory block, and glucose-positive aspirated fluid. The catheter was managed as CSA with fentanyl-based analgesia under strict monitoring. Although frequent breakthrough pain required rescue boluses, the vaginal delivery was achieved uneventfully. The patient developed a post-dural puncture headache that resolved after an epidural blood patch.Conclusions: This case illustrates the importance of early recognition of inadvertent intrathecal catheter placement and demonstrates that safe labor analgesia can be achieved through conversion to CSA with careful catheter management and close monitoring.","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":"12 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13677652/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149220340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Hemodynamic management, including for left ventricular outflow tract obstruction, in an infant with ACTH-independent Cushing syndrome undergoing adrenal tumor removal: a case report. 血流动力学处理，包括左心室流出道梗阻，1例acth非依赖性库欣综合征婴儿接受肾上腺肿瘤切除：1例报告

IF 1.2

JA Clinical Reports Pub Date : 2026-07-11 DOI: 10.1186/s40981-026-00868-2

Mariko Saito, Maiko Hosokawa, Kenichi Masui

{"title":"Hemodynamic management, including for left ventricular outflow tract obstruction, in an infant with ACTH-independent Cushing syndrome undergoing adrenal tumor removal: a case report.","authors":"Mariko Saito, Maiko Hosokawa, Kenichi Masui","doi":"10.1186/s40981-026-00868-2","DOIUrl":"10.1186/s40981-026-00868-2","url":null,"abstract":"Background: Adrenocorticotropic hormone (ACTH)-independent Cushing syndrome is extremely rare in children, with moon face, central obesity, buffalo hump, and hypertension as typical characteristics. We focused on perioperative hemodynamic management because this patient had left ventricular outflow tract obstruction (LVOTO), which is a rare sequela.Case description: A 6-month-old boy with ACTH-independent Cushing syndrome and sustained hypertension, with a cortisol level of 49.0 µg·dL- 1, was scheduled to undergo open adrenal tumor resection. Since the preoperative echocardiogram showed left ventricular hypertrophy and LVOTO, preoperative fluid loading was performed over 2 days to optimize fluid volume. For anesthesia induction, the ramp position helped maintain airway patency. Intraoperative and postoperative hemodynamics were generally stable, and hypertension during tumor manipulation was managed by titrating sevoflurane concentration.Conclusions: An excessive cortisol level with Cushing syndrome can rarely cause LVOTO in an infant. Not only airway management but also hemodynamic management, including preoperative management, would be essential.","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13638925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148421282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Overlapping clinical features of transfusion-related acute lung injury and anaphylactic shock during general anesthesia: a case report. 全麻期间输血相关急性肺损伤与过敏性休克重叠临床特征1例报告。

IF 1.2

JA Clinical Reports Pub Date : 2026-07-04 DOI: 10.1186/s40981-026-00867-3

Masashi Inoue, Akiko Taniguchi, Masato Morita

{"title":"Overlapping clinical features of transfusion-related acute lung injury and anaphylactic shock during general anesthesia: a case report.","authors":"Masashi Inoue, Akiko Taniguchi, Masato Morita","doi":"10.1186/s40981-026-00867-3","DOIUrl":"10.1186/s40981-026-00867-3","url":null,"abstract":"Background: Transfusion-related acute lung injury (TRALI) and anaphylactic shock are rare but life-threatening transfusion-related complications. Differentiating between these conditions during general anesthesia is difficult because subjective symptoms cannot be assessed and intraoperative diagnostic evaluation is limited.Case presentation: A 40-year-old woman undergoing surgery for ovarian cancer under general anesthesia developed acute hypoxemia during transfusion. After completion of the transfusion, she developed sudden hypotension, tachycardia, and generalized erythema, which responded promptly to adrenaline administration. Respiratory failure persisted, and frothy sputum appeared in the endotracheal tube. Postoperative chest radiography showed bilateral pulmonary infiltrates, while echocardiography revealed preserved cardiac function. Anti-human leukocyte antigen (HLA) class I and II antibodies were detected in the transfused fresh frozen plasma, and serum tryptase levels were elevated postoperatively.Conclusions: This case demonstrated overlapping clinical features of TRALI and anaphylactic shock during general anesthesia. Although donor anti-HLA antibodies supported the possibility of TRALI, severe anaphylaxis alone could not be completely excluded as an explanation for the pulmonary edema.","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13627637/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148387654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Opsoclonus revealing underlying multiple system atrophy: a case report. 斜视显示潜在的多系统萎缩：1例报告。

IF 1.2

JA Clinical Reports Pub Date : 2026-07-03 DOI: 10.1186/s40981-026-00865-5

Hiromi Kawano, Shotaro Sakimura, Ken Yamaura

{"title":"Opsoclonus revealing underlying multiple system atrophy: a case report.","authors":"Hiromi Kawano, Shotaro Sakimura, Ken Yamaura","doi":"10.1186/s40981-026-00865-5","DOIUrl":"10.1186/s40981-026-00865-5","url":null,"abstract":"Background: Delayed emergence from general anesthesia has multiple etiologies; in rare cases, it may unmask an unrecognized neurodegenerative disorder.Case presentation: A 64-year-old man underwent laparoscopic cholecystectomy under general anesthesia. No neurological abnormalities were identified preoperatively. After surgery, response to verbal stimuli was inadequate; however, other extubation criteria were met and he was extubated. Approximately 45 min later, rapid nystagmus-like eye movements consistent with opsoclonus developed, initially oscillating horizontally and then vertically, and persisted for about six minutes. A similar episode recurred 125 min after extubation. Head computed tomography showed no acute lesions but revealed marked cerebellar and brainstem atrophy. Subsequent neurological evaluation, including magnetic resonance imaging demonstrating the \"hot cross bun\" sign, fulfilled the Movement Disorder Society diagnostic criteria for clinically established multiple system atrophy with predominant parkinsonism.Conclusions: In unexplained delayed emergence from general anesthesia, opsoclonus should prompt evaluation for an underlying neurodegenerative disorder.","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13627527/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148375782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Beta-trace protein levels in epidural fluid and cerebrospinal fluid: a comparative analysis : Discriminative ability based on receiver operating characteristic analysis. 硬膜外液和脑脊液中β -微量蛋白水平的比较分析：基于受者操作特征分析的判别能力。

IF 1.2

JA Clinical Reports Pub Date : 2026-06-23 DOI: 10.1186/s40981-026-00866-4

Misuzu Hayashi, Kota Kamizato, Manabu Kakinohana

{"title":"Beta-trace protein levels in epidural fluid and cerebrospinal fluid: a comparative analysis : Discriminative ability based on receiver operating characteristic analysis.","authors":"Misuzu Hayashi, Kota Kamizato, Manabu Kakinohana","doi":"10.1186/s40981-026-00866-4","DOIUrl":"10.1186/s40981-026-00866-4","url":null,"abstract":"Background: Distinguishing cerebrospinal fluid (CSF) from epidural fluid is important when the origin of aspirated fluid is uncertain during neuraxial procedures. We evaluated the discriminative ability of β-trace protein (BTP).Methods: Epidural samples were obtained via epidural catheters after local anesthetic administration, and CSF samples during spinal anesthesia. Glucose, total protein, and BTP were measured, and receiver operating characteristic (ROC) analyses were performed.Results: BTP levels were markedly higher in CSF than in epidural samples, with no overlap. Glucose overlapped between groups, whereas total protein showed limited differences. ROC analysis demonstrated excellent discrimination for BTP (AUC = 1.000) under the present study conditions, outperforming glucose (AUC = 0.904) and total protein (AUC = 0.633). For glucose, the optimal cutoff was 56.5 mg/dL (sensitivity 83.3%, specificity 90.0%). For BTP, any cutoff between 0.42-4.03 mg/L achieved 100% sensitivity and specificity within this dataset.Conclusions: BTP shows strong discrimination between CSF and epidural fluid.","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13542016/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148301803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Refractory remimazolam-induced anaphylaxis and suspected Kounis syndrome requiring extracorporeal cardiopulmonary resuscitation: a case report. 难治性雷马唑仑引起的过敏反应和疑似库尼斯综合征需要体外心肺复苏：1例报告。

IF 1.2

JA Clinical Reports Pub Date : 2026-05-26 DOI: 10.1186/s40981-026-00862-8

Hajime Kotsubo, Takumi Taniguchi

{"title":"Refractory remimazolam-induced anaphylaxis and suspected Kounis syndrome requiring extracorporeal cardiopulmonary resuscitation: a case report.","authors":"Hajime Kotsubo, Takumi Taniguchi","doi":"10.1186/s40981-026-00862-8","DOIUrl":"10.1186/s40981-026-00862-8","url":null,"abstract":"Background: Kounis syndrome (KS) is an allergic acute coronary syndrome that may precipitate severe perioperative cardiovascular collapse. This study reports a case of remimazolam-induced refractory anaphylaxis complicated by KS and successfully treated with early extracorporeal cardiopulmonary resuscitation (ECPR).Case presentation: A 69-year-old male with atrial fibrillation was scheduled for lung resection. After induction of anesthesia with remimazolam, he developed abrupt tachycardia, coughing, and circulatory collapse with ST-segment elevation. Despite repeated adrenaline doses, he progressed to cardiac arrest. Venoarterial extracorporeal membrane oxygenation was initiated during cardiopulmonary resuscitation. Return of spontaneous circulation occurred 15 min after the cardiac arrest. The patient recovered without neurological sequelae. Elevated serum tryptase levels (49.5 µg/L; 24-h postonset: 4.5 µg/L) and positive intradermal testing suggested remimazolam-induced anaphylaxis. Coronary computed tomography revealed no stenosis, compatible with suspected type 1 KS.Conclusions: Remimazolam-induced anaphylaxis may be complicated by suspected KS. In refractory anaphylaxis complicated by cardiac arrest, early ECPR may be critical to survival.","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13385319/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148030547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Refractory anaphylactic shock complicated by acute right heart failure during anesthetic induction in a patient with a left ventricular assist device: a case report. 顽固性过敏性休克并发急性右心衰在麻醉诱导患者与左心室辅助装置：1例报告。

IF 1.2

JA Clinical Reports Pub Date : 2026-05-25 DOI: 10.1186/s40981-026-00864-6

Shohei Kaneko, Sojiro Matsumoto, Taiga Ichinomiya, Ushio Higashijima, Motohiro Sekino, Tetsuya Hara

{"title":"Refractory anaphylactic shock complicated by acute right heart failure during anesthetic induction in a patient with a left ventricular assist device: a case report.","authors":"Shohei Kaneko, Sojiro Matsumoto, Taiga Ichinomiya, Ushio Higashijima, Motohiro Sekino, Tetsuya Hara","doi":"10.1186/s40981-026-00864-6","DOIUrl":"10.1186/s40981-026-00864-6","url":null,"abstract":"Background: Anaphylaxis in patients with a left ventricular assist device (LVAD) may critically reduce LVAD flow, particularly when the right ventricular function is impaired.Case presentation: A 51-year-old man with a HeartMate III LVAD developed bronchospasm, profound hypotension, and decreased LVAD flow during anesthetic induction for endoscopic sinus surgery. The shock remained refractory despite epinephrine boluses and continuous infusions of epinephrine, norepinephrine, and vasopressin. Transesophageal echocardiography revealed severe right ventricular dilatation, leftward septal shift, and reduced left ventricular size, findings consistent with acute right heart failure (RHF). Treatment was escalated to include dobutamine, olprinone, and inhaled nitric oxide, achieving recovery of blood pressure and LVAD flow. Elevated serum tryptase supported the diagnosis of anaphylaxis, and a positive intradermal test identified remimazolam as the cause.Conclusions: Successful anaphylaxis management in LVAD recipients may require rapid recognition and treatment of acute RHF in addition to standard treatment including epinephrine.","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13385278/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148015394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Ultrasound identification of absent rectus abdominis muscle after omphalocele repair altered regional anesthesia strategy in pediatric cardiac surgery: a case report. 超声识别脐膨出修复后改变小儿心脏手术区域麻醉策略的腹直肌缺失：1例报告。

IF 1.2

JA Clinical Reports Pub Date : 2026-05-25 DOI: 10.1186/s40981-026-00863-7

Tomohiro Yamamoto, Teppei Yamada, Shuichi Shiraishi

{"title":"Ultrasound identification of absent rectus abdominis muscle after omphalocele repair altered regional anesthesia strategy in pediatric cardiac surgery: a case report.","authors":"Tomohiro Yamamoto, Teppei Yamada, Shuichi Shiraishi","doi":"10.1186/s40981-026-00863-7","DOIUrl":"10.1186/s40981-026-00863-7","url":null,"abstract":"Background: Previous abdominal wall repair may alter the rectus abdominis muscle structure and render rectus sheath block (RSB) infeasible in pediatric cardiac surgery.Case presentation: A 5-year-old boy with a history of siloplasty and omphalocele repair underwent right ventricle-to-pulmonary artery conduit replacement. Deep parasternal intercostal plane block and RSB had been planned. However, ultrasound pre-scanning failed to identify the rectus abdominis muscle in the upper abdomen, and the liver was visualized immediately beneath the abdominal wall. Preoperative computed tomography confirmed absence of the rectus abdominis muscle, rendering RSB anatomically infeasible. An alternative upper abdominal wall block was performed. The patient was extubated 2 h after admission to the intensive care unit and had no apparent discomfort from the chest and mediastinal drains.Conclusions: Preprocedural ultrasound assessment can identify altered rectus abdominis muscle structure and help anesthesiologists select a safer and potentially effective alternative analgesic strategy when RSB is not feasible.","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13385318/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148015441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0