Journal of Anaesthesia and Critical Care Reports最新文献_第2页

Traumatic Acinetobacter Baumannii Meningitis Without Neuro surgical Intervention– A Rare Case Report 创伤性鲍曼不动杆菌性脑膜炎无神经外科干预-一例罕见病例报告

Journal of Anaesthesia and Critical Care Reports Pub Date : 2021-01-10 DOI: 10.13107/jaccr.2021.v07i01.170

V. Santhosh, M. N. Mukunthan, A. Priya, Rajaram K. Manoharan

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Opioid-Free Naloxone Emergence Under Dexmedetomidine: A Case Report 右美托咪定治疗下无阿片类药物纳洛酮出现一例报告

Journal of Anaesthesia and Critical Care Reports Pub Date : 2021-01-10 DOI: 10.13107/jaccr.2021.v07i01.167

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Pediatric ANCA- Associated Vasculitis Presenting with Acute Postoperative Subglottic Stenosis: A Case Report 以急性术后声门下狭窄为表现的小儿ANCA相关血管炎1例报告

Journal of Anaesthesia and Critical Care Reports Pub Date : 2021-01-10 DOI: 10.13107/jaccr.2021.v07i01.168

Diana T. Phan, John Q Le

{"title":"Pediatric ANCA- Associated Vasculitis Presenting with Acute Postoperative Subglottic Stenosis: A Case Report","authors":"Diana T. Phan, John Q Le","doi":"10.13107/jaccr.2021.v07i01.168","DOIUrl":"https://doi.org/10.13107/jaccr.2021.v07i01.168","url":null,"abstract":"Introduction: Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) often present with nonspecific constitutional symptoms. However, there has been increasing recognition of a subgroup of young, female AAV patients who are at higher risk for isolated subglottic airway disease.\u0000Case Presentation: We report a rare case of a 17-year-old female with undiagnosed ANCA-associated vasculitis who presents with acute, life threatening subglottic stenosis requiring emergent intubation after routine surgery.\u0000Conclusion: Much of the research on ANCA-associated vasculitis have been based on adult cases, however many pediatric patients may not follow the same diagnostic and clinical presentations. Clinicians should be vigilant in recognizing a subgroup of vasculitis patients who are often young, female, and have a higher prevalence of subglottic stenosis. Symptoms should be promptly worked up and initiation of immunosuppressive therapy is necessary to prevent life threatening complications and end-organ damage.\u0000Keywords: ANCA-associated vasculitis, Subglottic stenosis, Granulomatosis with polyangiitis.","PeriodicalId":448126,"journal":{"name":"Journal of Anaesthesia and Critical Care Reports","volume":"45 15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124628950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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The challenges in managing a case of refractory and overwhelming shock caused by Systemic Capillary Leak Syndrome 处理一例系统性毛细血管渗漏综合征引起的难治性和压倒性休克的挑战

Journal of Anaesthesia and Critical Care Reports Pub Date : 2021-01-10 DOI: 10.13107/jaccr.2021.v07i01.166

Aidan Spring, E. Lynn

{"title":"The challenges in managing a case of refractory and overwhelming shock caused by Systemic Capillary Leak Syndrome","authors":"Aidan Spring, E. Lynn","doi":"10.13107/jaccr.2021.v07i01.166","DOIUrl":"https://doi.org/10.13107/jaccr.2021.v07i01.166","url":null,"abstract":"Introduction: Systemic Capillary Leak Syndrome (SCLS) or Clarkson syndrome is a rare condition characterised by vascular hyperpermeability. The frequency and severity of disease flares is highly variable. The disease is associated with significant morbidity and mortality. We describe a fulminant episode in a patient known to have the condition.\u0000Case Report: A forty-four-year-old woman self-presented with malaise and dyspnoea. Over twelve hours she developed refractory shock despite aggressive volume resuscitation and vasopressor use. She ultimately succumbed to the condition despite aggressive treatment which included fasciotomies of all four limbs for compartment syndrome and a laparostomy for suspected abdominal compartment syndrome.\u0000Conclusion: SCLS should be considered in the context of hypotension, haemoconcentration, and hypoalbuminaemia in the absence of albuminuria. Management of acute SLCS episodes can prove extremely challenging for both the intensivist and the anaesthetist. The underlying pathophysiology is unique and fascinating. Supportive care in an intensive care setting is the only established treatment. There are still no proven pharmacotherapies to modulate the course of acute episodes of this disease.\u0000Keywords: Shock states; Capillary leak; Compartment syndrome.","PeriodicalId":448126,"journal":{"name":"Journal of Anaesthesia and Critical Care Reports","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122732182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Extracorporeal Life Support for Massive Hemoptysis and Acute Lung Injury Due to ANCA Negative Vasculitis ANCA阴性血管炎所致大咯血和急性肺损伤的体外生命支持

Journal of Anaesthesia and Critical Care Reports Pub Date : 2021-01-10 DOI: 10.13107/jaccr.2021.v07i01.165

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Fluoroscopy comes to the rescue in anaesthesia management of a case of ankylosing spondylitis 透视术在强直性脊柱炎麻醉治疗中的作用

Journal of Anaesthesia and Critical Care Reports Pub Date : 2021-01-10 DOI: 10.13107/jaccr.2021.v07i02.180

{"title":"Fluoroscopy comes to the rescue in anaesthesia management of a case of ankylosing spondylitis","authors":"","doi":"10.13107/jaccr.2021.v07i02.180","DOIUrl":"https://doi.org/10.13107/jaccr.2021.v07i02.180","url":null,"abstract":"Ankylosing spondylosis is always a challenge when patient has severe deformities to choose between general anaesthesia versus regional anaesthesia. Regional anaesthesia is always a choice either at institutionally or at smaller private hospital set ups.\u0000\u0000Schewley and colleagues compared regional versus general anaesthesia over 10 years and shown that regional anaesthesia is equally good choice.[1]\u0000\u0000There are many case reports which suggest that regional anaesthesia could be a safer option in severe Ankylosing spondylosis patients.[2]\u0000\u0000Author has managed to achieve neuraxial access by using fluoroscopy. However, interpretation of images by fluoroscopy could be difficult for anaesthetists without chronic pain management background. Also, availability of fluoroscopy could be variable as it may be busy in other theatres to be available later for surgery.\u0000\u0000Use of ultrasound to view spaces could be useful in cases with difficult neuraxial access to find the space. Most of the anaesthetists practising regional anaesthesia have expertise in using ultra-sound and also are comfortable to interpret the images. USG could also be helpful in pre-operative setting to identify and plan for central neuraxial blockade. [4]\u0000\u0000There are many case reports of use of USG guidance for neuraxial anaesthesia in such cases. [3]\u0000\u0000However, central neuraxial blocks in these patient comes with risks. The placement of epidural anaesthesia is technically difficult and is associated with an increased risk of an epidural haematoma.\u0000\u0000Wulf reported five out of 51 patients with spinal haematoma occurred in patients with AS in a comprehensive review of spinal haematoma associated with epidural anaesthesia over a 30?year period. These were related to difficult or traumatic insertion. In this his review article, he also mentions Ankylosing spondylosis as one of the risk factor for spinal or epidural haemoatoma. [5]\u0000\u0000Li et al also present a case report where patient developed epidural haematoma after epidura","PeriodicalId":448126,"journal":{"name":"Journal of Anaesthesia and Critical Care Reports","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131871982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Peri-Operative Stress-Related Cardiomyopathy Following Paediatric Liver Transplant– A Case Series 儿童肝移植术后围手术期压力相关心肌病-一个病例系列

Journal of Anaesthesia and Critical Care Reports Pub Date : 2020-09-10 DOI: 10.13107/jaccr.2020.v06i03.159

引用次数: 0

Gestational Trophoblastic Disease Spectrum: Case Report and Anaesthetic Implications 妊娠滋养细胞疾病谱:病例报告和麻醉意义

Journal of Anaesthesia and Critical Care Reports Pub Date : 2020-09-10 DOI: 10.13107/jaccr.2020.v06i03.162

{"title":"Gestational Trophoblastic Disease Spectrum: Case Report and Anaesthetic Implications","authors":"","doi":"10.13107/jaccr.2020.v06i03.162","DOIUrl":"https://doi.org/10.13107/jaccr.2020.v06i03.162","url":null,"abstract":"Gestational Trophoblastic Disease (GTD) is a spectrum of tumours with abnormal placental trophoblastic proliferation. They can be benign or malignant lesions. When they invade locally or metastasise, they are called Gestational Trophoblastic Neoplasia (GTN). Clinically, women present with history of amenorrhoea, abdominal pain, mild to severe vaginal bleed with or without symptoms due to metastases. Based on the organ of metastasis, symptoms may vary from breathlessness and cough with chest involvement to lethargy, loss of memory or seizures with brain metastasis. This entity ranges from pre-malignant conditions like hydatidiform mole and partial hydatidiform mole to neoplastic invasive mole, choriocarcinoma or rare type of epitheloid trophoblastic tumour. [1,2] Undetected hyperthyroidism can complicate GTD and present with potential significant complications like cardiac failure and arrhythmias. Manifestations of the disease are attributed to excess secretion of human chorionic gonadotropin (HCG) that has thyrotrophic activity due to its structural similarity. [3,4] The incidence reported in Asian population is as high as 1:400, three times higher. In majority of cases, early diagnosis and treatment provide complete cure in GTD. In 20%, even locally invasive disease, with or without metastasis can be life threatening. [5] Surgical removal is the definitive treatment. Peri-operative anaesthetic management of patients with multiple system involvement as a result of extensive disease can be challenging, hence from anaesthetic perspective it is essential to understand the pathophysiology, clinical presentations and potential complications of molar pregnancy. We hereby report successful management of two cases presenting at different areas of the disease spectrum.\u0000Keywords: Molar pregnancy; Choriocarcinoma; Tropoblastic disease.","PeriodicalId":448126,"journal":{"name":"Journal of Anaesthesia and Critical Care Reports","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122673296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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Erector Spinae Plane Block– An Analgesic Technique for Laparoscopic Liver Resection: A Case Series 竖脊肌平面阻滞-腹腔镜肝切除术的镇痛技术:一个案例系列

Journal of Anaesthesia and Critical Care Reports Pub Date : 2020-09-10 DOI: 10.13107/jaccr.2020.v06i03.158

{"title":"Erector Spinae Plane Block– An Analgesic Technique for Laparoscopic Liver Resection: A Case Series","authors":"","doi":"10.13107/jaccr.2020.v06i03.158","DOIUrl":"https://doi.org/10.13107/jaccr.2020.v06i03.158","url":null,"abstract":"Introduction: Postoperative pain after liver surgery can be significant and yet difficult to manage. Epidural analgesia is widely used for pain relief after liver surgery. However there has been a progressive reduction in the use of epidural analgesia within an enhanced recovery program. The erector spinae plane block is a recently described regional anesthetic technique for providing abdominal analgesia when performed at the level of the T7 transverse process. Its mechanism of action is not yet clear, despite this providing somatic and visceral analgesia during surgery.\u0000Cases presentation: We report five patients undergoing laparoscopic liver resection in which the somatic and visceral intraoperative pain were covered by the right erector spinae plane block. In addition, a transversus abdominis plane plus oblique subcostal transversus abdominis plane blocks were performed on the left hemisome to cover the somatic pain due to skin incision and laparoscopic ports insertion. For postoperative pain relief, a catheter was inserted during the execution of the erector spinae plane block and a levobupivacaine infusion was maintained for 36 hr through it.\u0000Conclusions: A continuous right erector spinae plane block could be an effective analgesic technique in patients undergoing laparoscopic liver resection. However, further prospective studies with large number of patients are needed to evaluate the effectiveness of this block in liver surgery.\u0000Keywords: ESP block ; Erector spinae plane block ; Regional anesthesia ; Hepatic surgery ; Pain management.","PeriodicalId":448126,"journal":{"name":"Journal of Anaesthesia and Critical Care Reports","volume":"45 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127018090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Total Lung Lavage using THRIVE for Pre-oxygenation and Oxygen Insufflation During Intubation: Our Initial Experience of Two Cases 气管插管时用THRIVE进行全肺灌洗预充氧和充氧:我们两例的初步经验

Journal of Anaesthesia and Critical Care Reports Pub Date : 2020-09-10 DOI: 10.13107/jaccr.2020.v06i03.157

{"title":"Total Lung Lavage using THRIVE for Pre-oxygenation and Oxygen Insufflation During Intubation: Our Initial Experience of Two Cases","authors":"","doi":"10.13107/jaccr.2020.v06i03.157","DOIUrl":"https://doi.org/10.13107/jaccr.2020.v06i03.157","url":null,"abstract":"Introduction: Pulmonary alveolar proteinosis (PAP) is a rare disease characterized by deposition of lipoproteinaceous material in the alveoli secondary to abnormal processing of surfactant by macrophages. Total-lung lavage (TLL); a gold standard management for this disease entails washing out the proteinaceous material from the alveoli and re-establish effective oxygenation and ventilation. Transnasal humidified rapid-insufflation ventilatory exchange (THRIVE), utilizes apnoeic oxygenation to extend the apnoeic window and delay rapid de-saturation common in these cases; thus allowing for safer intubation. We would like to share our experience of two cases of TLL for PAP in which we used THRIVE for pre-oxygenation and apnoeic oxygenation during intubation. To our knowledge this is the first case report demonstrating the use of THRIVE in a case of TLL in literature.\u0000Case presentation: We had two patients posted for TLL who were suffering from PAP; both had presented with breathlessness of increasing severity over the last few months. Both patients were young (35 & 40 yrs old) and had no other co-morbidities. Their baseline oxygen saturations (SpO2) and partial pressure of oxygen in blood (pO2) on air were on the lower side. Hence the decision was taken to pre-oxygenate them using THRIVE and to also use THRIVE during intubation to improve their tolerance to apnoea during intubation.\u0000Conclusion: When used for pre-oxygenation and oxygen insufflation during intubation THRIVE prolongs the tolerable apnoea time and delays de-saturation during intubation.\u0000Keywords: Pulmonary alveolar proteinosis (PAP), Total Lung Lavage (TLL), Transnasal humidified rapid-insufflation ventilatory exchange (THRIVE).","PeriodicalId":448126,"journal":{"name":"Journal of Anaesthesia and Critical Care Reports","volume":"106 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124840594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0