1/2. General anaesthesia and the hypereosinophilic syndrome: severe postoperative complications in two patients.Two patients with markedly increased eosinophil counts developed severe postoperative complications after general anaesthesia. One patient suffered life-threatening adult Respiratory Distress Syndrome (ARDS), while the other presented with a coagulopathy and less severe respiratory problems. The hypereosinophilic syndrome is described and the possibility of a role of eosinophils in the pathogenesis of tissue injury is discussed. These cases suggest that, in patients with marked eosinophilia requiring general anaesthesia, perioperative steroid cover is advisable. This may reduce or prevent serious lung damage and other complications.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
2/2. Upper airway oedema following autologous blood transfusion from a wound drainage system.We report a case of a 70-yr-old white woman who underwent a revision of a total hip arthroplasty under general anaesthesia. The intraoperative course was stable without any complications and the estimated blood loss was 2500 ml. The patient received an autologous transfusion of blood from a wound drainage system in the recovery room. The transfusion was followed immediately by marked respiratory distress and upper airway oedema. She required emergency tracheal intubation and mechanical pulmonary ventilation. A coagulopathy also developed which was treated and resolved within 12 hr of the capillary leak phenomenon. The trachea was extubated on the first postoperative day and she had an uneventful course until discharge from the hospital two days later. We discuss the possible, aetiology of such a reaction to autologous blood including complement and platelet activation. It is suggested that reinfusion of nonwashed shed blood from a wound drainage system may present a hazard even though the fluid was autologous in origin.- - - - - - - - - - ranking = 0.16666666666667keywords = anaesthesia (Clic here for more details about this article) |