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Perioperative Autonomic Dysfunction in a Patient With Charcot-Marie-Tooth Disease: A Case Report. 腓骨肌-玛丽肌病患者围手术期自主神经功能障碍1例。
IF 0.5
A&A Practice Pub Date : 2023-09-01 DOI: 10.1213/XAA.0000000000001722
Wissam Maroun, Carol Abi Shadid, Mohamed Fayed, Carine Foz, Jean Beresian, Ahmad Oseili
{"title":"Perioperative Autonomic Dysfunction in a Patient With Charcot-Marie-Tooth Disease: A Case Report.","authors":"Wissam Maroun,&nbsp;Carol Abi Shadid,&nbsp;Mohamed Fayed,&nbsp;Carine Foz,&nbsp;Jean Beresian,&nbsp;Ahmad Oseili","doi":"10.1213/XAA.0000000000001722","DOIUrl":"https://doi.org/10.1213/XAA.0000000000001722","url":null,"abstract":"<p><p>Autonomic dysfunction can lead to unexpected hemodynamic instability during surgery, and best practices for the perioperative care of patients with this condition are not well-defined. We report the case of a 63-year-old woman with Charcot-Marie-Tooth disease who experienced perioperative autonomic dysfunction characterized by severe fluctuations in blood pressure while under spinal anesthesia. However, <1 month later, a second hip surgery performed under general anesthesia with special precautions resulted in an uncomplicated perioperative course, with only mild fluctuations in blood pressure.</p>","PeriodicalId":7307,"journal":{"name":"A&A Practice","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10295562","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
Pediatric Renal Transplant With Dilated Cardiomyopathy: A Stepwise Hemodynamic Management-A Case Report. 儿童肾移植合并扩张型心肌病:分步血流动力学处理一例报告。
IF 0.5
A&A Practice Pub Date : 2023-09-01 DOI: 10.1213/XAA.0000000000001709
Kashish Garg, Choro Athiphro Kayina, Kamal Kajal, Krishna Prasad Gourav, Ashish Aditya, Sameer Sethi, Deepesh B Kenwar
{"title":"Pediatric Renal Transplant With Dilated Cardiomyopathy: A Stepwise Hemodynamic Management-A Case Report.","authors":"Kashish Garg,&nbsp;Choro Athiphro Kayina,&nbsp;Kamal Kajal,&nbsp;Krishna Prasad Gourav,&nbsp;Ashish Aditya,&nbsp;Sameer Sethi,&nbsp;Deepesh B Kenwar","doi":"10.1213/XAA.0000000000001709","DOIUrl":"https://doi.org/10.1213/XAA.0000000000001709","url":null,"abstract":"<p><p>Here we have described the anesthetic management of a 10-year-old patient having uremia-induced dilated cardiomyopathy for a living-related adult to pediatric renal transplant. Maintaining optimal hemodynamics, especially during the reperfusion phase, is crucial for maintaining graft perfusion. However, dilated cardiomyopathy limits indiscriminate fluid administration as it may cause congestive heart failure and pulmonary edema. We have described the fluid therapy algorithm based on the plethysmography variability index and velocity time integral at the left ventricular outflow tract, which was able to limit excessive fluid administration and maintain adequate perfusion pressures.</p>","PeriodicalId":7307,"journal":{"name":"A&A Practice","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10195560","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
Undiagnosed Factor VII Deficiency in Cardiac Surgery Complicated by Bleeding: A Case Report. 心脏手术合并出血的未确诊因子7缺乏1例报告。
IF 0.5
A&A Practice Pub Date : 2023-09-01 DOI: 10.1213/XAA.0000000000001713
Ziyad O Knio, Mickey S Ising, Kenan W Yount, Kenichi Tanaka, John S McNeil
{"title":"Undiagnosed Factor VII Deficiency in Cardiac Surgery Complicated by Bleeding: A Case Report.","authors":"Ziyad O Knio,&nbsp;Mickey S Ising,&nbsp;Kenan W Yount,&nbsp;Kenichi Tanaka,&nbsp;John S McNeil","doi":"10.1213/XAA.0000000000001713","DOIUrl":"https://doi.org/10.1213/XAA.0000000000001713","url":null,"abstract":"<p><p>Rare bleeding disorders in the perioperative period call for targeted resuscitation strategies. Factor VII deficiency, for instance, is often corrected with exogenous administration of recombinant factor VIIa. This activated clotting factor, initially designed for patients with hemophilia A or B with factor inhibitors, is gaining popularity as a salvage therapy for severe and persistent traumatic and surgical bleeding. This article describes the management of a cardiothoracic surgical patient with undiagnosed isolated factor VII deficiency who experienced significant postoperative bleeding which subsided after the administration of recombinant factor VIIa. In this case, EXTEM failed to detect a clotting factor deficiency.</p>","PeriodicalId":7307,"journal":{"name":"A&A Practice","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10200388","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
Auto-Brewery Syndrome and General Anesthesia: A Case Report. 自动酿酒综合征与全身麻醉:1例报告。
IF 0.5
A&A Practice Pub Date : 2023-09-01 DOI: 10.1213/XAA.0000000000001708
Brandon Key, Caroline M Sawicki, Bryant Cornelius, Gregory Ness, Andrew Herlich, Spencer D Wade
{"title":"Auto-Brewery Syndrome and General Anesthesia: A Case Report.","authors":"Brandon Key,&nbsp;Caroline M Sawicki,&nbsp;Bryant Cornelius,&nbsp;Gregory Ness,&nbsp;Andrew Herlich,&nbsp;Spencer D Wade","doi":"10.1213/XAA.0000000000001708","DOIUrl":"https://doi.org/10.1213/XAA.0000000000001708","url":null,"abstract":"Auto-brewery syndrome (ABS) is a rare condition in which ethanol is endogenously fermented by fungi in the gut following a carbohydrate-rich meal, resulting in intoxication. We present a case of a patient with ABS successfully undergoing general anesthesia for symptomatic wisdom tooth extraction. During previous anesthetics, the patient had experienced postoperative nausea and vomiting (PONV) and awareness under anesthesia. Patients with ABS can be optimized for anesthesia by assessing hepatic function, avoiding perioperative oral carbohydrates, increasing anesthetic depth, multimodal PONV prophylaxis, and avoidance of broad-spectrum antibiotics.","PeriodicalId":7307,"journal":{"name":"A&A Practice","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10233292","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
The Quality Improvement Fellow: Educating on Making the Difference. 质量改进人员:如何做出改变的教育。
IF 0.5
A&A Practice Pub Date : 2023-09-01 DOI: 10.1213/XAA.0000000000001715
Rodrigo O L Pereira, Tetsu Ohnuma, Nitin Mehdiratta, Nazish K Hashmi, Daneel M Patoli, Vijay Krishnamoorthy
{"title":"The Quality Improvement Fellow: Educating on Making the Difference.","authors":"Rodrigo O L Pereira,&nbsp;Tetsu Ohnuma,&nbsp;Nitin Mehdiratta,&nbsp;Nazish K Hashmi,&nbsp;Daneel M Patoli,&nbsp;Vijay Krishnamoorthy","doi":"10.1213/XAA.0000000000001715","DOIUrl":"https://doi.org/10.1213/XAA.0000000000001715","url":null,"abstract":"<p><p>The critical care medicine (CCM) fellowship is an opportunity for advanced anesthesiology trainees to refine their quality improvement (QI) skills. However, the short training period and inconsistent curricula make this challenging. The QI fellow (QIF) is described as an education program to provide consistent QI training during the CCM fellowship. The QIF is a mentored position to help manage data review, QI conferences, and improvement efforts within the CCM Division. The curriculum is focused on a QI education framework and mentored experiential learning. The QIF program is an opportunity for education and mentorship in the role of a CCM operational leader.</p>","PeriodicalId":7307,"journal":{"name":"A&A Practice","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10337441","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
Ultrasound Rounds: Anesthesiologist-Performed Intraoperative Point-of-Care Focused Assessment With Sonography in Trauma Examination Changes Surgical Management. 超声查房:麻醉医师进行的术中护理点重点评估与创伤检查中的超声检查改变了手术管理。
IF 0.5
A&A Practice Pub Date : 2023-08-01 DOI: 10.1213/XAA.0000000000001707
Caitlin A Bradley, McKenzie M Hollon
{"title":"Ultrasound Rounds: Anesthesiologist-Performed Intraoperative Point-of-Care Focused Assessment With Sonography in Trauma Examination Changes Surgical Management.","authors":"Caitlin A Bradley,&nbsp;McKenzie M Hollon","doi":"10.1213/XAA.0000000000001707","DOIUrl":"https://doi.org/10.1213/XAA.0000000000001707","url":null,"abstract":"<p><p>Focused Assessment with Sonography in Trauma (FAST) examinations have been performed for decades by surgeons during initial patient presentation for emergency care and surgical planning, as well as for guiding resuscitation. This case highlights how use of intraoperative FAST examinations performed by anesthesiologists can dramatically change patient management. Use by anesthesiologists perioperatively is an important skill, although it is not widely practiced.</p>","PeriodicalId":7307,"journal":{"name":"A&A Practice","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9989008","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
Oropharyngeal and Tongue Pulse Oximetry: The Rescue Solution? 口咽和舌脉血氧测量:拯救方案?
IF 0.5
A&A Practice Pub Date : 2023-08-01 DOI: 10.1213/XAA.0000000000001704
Ahed Zeidan, Ghassan Kanj
{"title":"Oropharyngeal and Tongue Pulse Oximetry: The Rescue Solution?","authors":"Ahed Zeidan,&nbsp;Ghassan Kanj","doi":"10.1213/XAA.0000000000001704","DOIUrl":"https://doi.org/10.1213/XAA.0000000000001704","url":null,"abstract":"","PeriodicalId":7307,"journal":{"name":"A&A Practice","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10030521","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
Propofol Induced Subacute Cutaneous Lupus Erythematosus: A Case Report. 异丙酚诱发亚急性皮肤红斑狼疮1例。
IF 0.5
A&A Practice Pub Date : 2023-08-01 DOI: 10.1213/XAA.0000000000001700
Joseph A Schoenfeldt, Michael A Howard, Deeba Masood, Daniel S Cormican
{"title":"Propofol Induced Subacute Cutaneous Lupus Erythematosus: A Case Report.","authors":"Joseph A Schoenfeldt,&nbsp;Michael A Howard,&nbsp;Deeba Masood,&nbsp;Daniel S Cormican","doi":"10.1213/XAA.0000000000001700","DOIUrl":"https://doi.org/10.1213/XAA.0000000000001700","url":null,"abstract":"<p><p>We report a case of a woman who experienced unexplained recurrent rashes of varying severity after multiple exposures to anesthesia, and then 2 successful surgeries under general anesthesia with no resultant rashes after removing propofol from her anesthetic plans. We infer her previous postanesthetic rashes were likely associated with drug-induced subacute cutaneous lupus erythematosus (DI-SCLE) triggered by propofol.</p>","PeriodicalId":7307,"journal":{"name":"A&A Practice","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/eb/ea/acc-17-e01700.PMC10467811.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10182892","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
In Response. 作为回应。
IF 0.5
A&A Practice Pub Date : 2023-08-01 DOI: 10.1213/XAA.0000000000001710
Brian Hall, Jason Bryant
{"title":"In Response.","authors":"Brian Hall,&nbsp;Jason Bryant","doi":"10.1213/XAA.0000000000001710","DOIUrl":"https://doi.org/10.1213/XAA.0000000000001710","url":null,"abstract":"","PeriodicalId":7307,"journal":{"name":"A&A Practice","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10021885","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
A Case of Chronic Penile Pain Successfully Treated With Dorsal Nerve Block. 背神经阻滞治疗慢性阴茎痛1例。
IF 0.5
A&A Practice Pub Date : 2023-08-01 DOI: 10.1213/XAA.0000000000001714
David D Watson, Xiaoying Zhu
{"title":"A Case of Chronic Penile Pain Successfully Treated With Dorsal Nerve Block.","authors":"David D Watson,&nbsp;Xiaoying Zhu","doi":"10.1213/XAA.0000000000001714","DOIUrl":"https://doi.org/10.1213/XAA.0000000000001714","url":null,"abstract":"<p><p>Chronic penile pain causes significant suffering in men, yet the management of chronic penile pain is not described in current literature. A patient presented with penile pain for 3 months following a tick bite. The pain was debilitating, and prevented him from working or performing routine activities. Extensive workup of the pain did not demonstrate an identifiable cause. The patient underwent dorsal nerve block (DNB), which provided immediate pain relief and continued to provide significant relief for several months. This is the first case of chronic penile pain that was successfully managed with DNB.</p>","PeriodicalId":7307,"journal":{"name":"A&A Practice","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10435005","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
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