1/4. Cardiac arrest during surgery and ventilation in the prone position: a case report and systematic review.We present a case report of successful resuscitation following cardiac arrest in a patient undergoing surgery in the prone position. A systematic review of the literature identified 22 further cases. risk factors for intra-operative cardiac arrest in patients in the prone position include: cardiac abnormalities in patients undergoing major spinal surgery, hypovolaemia, air embolism, wound irrigation with hydrogen peroxide, poor positioning and occluded venous return. Cardiac arrest is also a risk in the increasing number of patients with acute respiratory distress syndrome ventilated in the prone position. Management of prone cardiac arrest may be improved by identification of high-risk patients, careful patient positioning, use of invasive monitoring and placement of self-adhesive defibrillator paddles. Suitable techniques for cardiopulmonary resuscitation including methods for chest compression, defibrillation and the management of air embolism are discussed.- - - - - - - - - - ranking = 1keywords = chest (Clic here for more details about this article) |
2/4. Use of desmopressin and erythropoietin in an anaemic Jehovah's Witness patient with severely impaired coagulation capacity undergoing stentless aortic valve replacement.Cardiac surgery in Jehovah's Witness patients remains a challenge in the presence of concomitant congenital or acquired coagulation disorders and anaemia. We report a case of a 66-year-old female Jehovah's Witness suffering from severe calcified aortic valve stenosis requiring aortic valve replacement. The anaemic patient suffered from concomitant platelet dysfunction and deficiency of factors V and VII due to gammopathy of immunoglobulin g. The patient was preoperatively treated with recombinant erythropoietin in combination with folic acid and iron, which resulted in an increase of the haematocrit from 0.335 to 0.416 after 22 days of treatment. Haemostasis was improved by high dose aprotinin and additional desmopressin, which could be demonstrated to be effective by a preoperative test. The patients intra- and postoperative course was uneventful, her total chest tube loss was 130 ml, and she was able to be discharged without the need of any blood transfusions. The beneficial properties of erythropoietin and desmopressin in Jehovah's Witness patients are discussed.- - - - - - - - - - ranking = 1keywords = chest (Clic here for more details about this article) |
3/4. Migration of a dislodged tip of an ultrasound lithotripter probe to the pulmonary artery: a rare complication of percutaneous nephrolithotomy.A 44-year-old man underwent percutaneous nephrolithotomy for a left renal staghorn stone. During the procedure, the tip of the ultrasound lithotripter dislodged from the probe rod when the renal stone was being disintegrated. The tip immediately disappeared from the field of nephroscopic vision. Despite a thorough search, the tip could not be found. Postoperative chest radiography revealed a foreign body, shaped like a lithotripter probe tip, located in the lingular branch of the left pulmonary artery. Eventually, left thoracotomy was performed to remove the foreign body. To our knowledge, this rare complication has never been reported before.- - - - - - - - - - ranking = 1keywords = chest (Clic here for more details about this article) |
4/4. Preoperative embolization in the treatment of choroid plexus papilloma in an infant. Case report.The authors report a case of preoperative embolization and resection of a choroid plexus papilloma of the lateral ventricle in a 4-month-old boy. These vascular tumors of the central nervous system present a significant intraoperative bleeding risk. Attempts at preoperative embolization to reduce the bleeding risk have rarely succeeded because of the small and tortuous vessels feeding these tumors in infants. The case presented here supports the feasibility of preoperative embolization as a therapeutic adjunct in infants.- - - - - - - - - - ranking = 181.52495536652keywords = plexus (Clic here for more details about this article) |