1/2. Negative pressure pulmonary oedema in the medical intensive care unit.OBJECTIVE: Negative pressure pulmonary oedema (NPPE) occurring in the medical intensive care unit (MICU) is an uncommon, probably under-diagnosed, but life-threatening condition. DESIGN: Retrospective data collection. SETTING: Medical intensive care unit in a 1,500-bedded tertiary care hospital. patients AND PARTICIPANTS: Five patients were diagnosed between January 1998 and January 2002. INTERVENTIONS: None. MEASUREMENTS AND RESULTS: Five patients were diagnosed to have NPPE from different aetiologies. These were acute epiglottitis, post-stenting of right bronchus intermedius stenosis, strangulation, compression from a goitre and one patient developed diffuse alveolar haemorrhage after biting the endotracheal tube during recovery from anaesthesia. All patients responded rapidly to supplemental oxygen, positive pressure ventilation and correction of underlying aetiologies. Pulmonary oedema resolved rapidly. CONCLUSIONS: There is a large spectrum of aetiologies causing NPPE in the medical intensive care unit.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
2/2. Resection of an unusually large goitre.This paper reports the resection of a benign non-toxic goitre measuring 75 X 60 X 45 cm in a patient aged 48 who was unable to walk or sit because of the size of the goitre. The tumour proved to arise from the right half of the thyroid. A right-sided hemistrumectomy was performed under local anaesthesia with the patient prone. A temporary tracheostomy was established. The postoperative course was uneventful apart from slight necrosis of the wound edge. The patient was discharged in good health on the twentieth postoperative day.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |