1/7. Fatal pulmonary haemorrhage during anaesthesia for bronchial artery embolization in cystic fibrosis.Three children with cystic fibrosis (CF) had significant pulmonary haemorrhage during anaesthetic induction prior to bronchial artery embolization (BAE). Haemorrhage was associated with rapid clinical deterioration and subsequent early death. We believe that the stresses associated with intermittent positive pressure ventilation (IPPV) were the most likely precipitant to rebleeding and that the inability to clear blood through coughing was also an important factor leading to deterioration. Intermittent positive pressure ventilation should be avoided when possible in children with CF with recent significant pulmonary haemorrhage.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
2/7. hoarseness due to leech ingestion.This paper presents a case of hoarseness caused by the pharyngolaryngeal localization of a leech. This pathological lesion is extremely rare in western European countries, but is more frequent in endemic areas. Possibly lethal dyspnoea, haemoptysis or haematemesis can be the revealing symptoms. When the diagnosis is suspected simple examination under anaesthesia and removal of the leech will effect a cure.- - - - - - - - - - ranking = 0.25keywords = anaesthesia (Clic here for more details about this article) |
3/7. leeches in the larynx.This is a report of four patients who inhaled leeches. They presented with severe attacks of inspiratory stridor, difficulty in breathing and spitting blood. Indirect laryngoscopy revealed a dark greenish living foreign body in the larynx in each case. laryngoscopy was performed with local anaesthesia in two of the cases and general anaesthesia was used in the other two. The leeches were removed with forceps.- - - - - - - - - - ranking = 0.5keywords = anaesthesia (Clic here for more details about this article) |
4/7. A case of pulmonary haemorrhage following jet ventilation for vocal cord surgery.INTRODUCTION: This case report highlights haemoptysis occurring after post-extubation laryngospasm. CLINICAL PICTURE: General anaesthesia using Sanders jet ventilation with a Benjamin tube was administered for a patient undergoing vocal cord biopsy. He developed laryngospasm followed by significant pulmonary haemorrhage and widespread crepitations in the lung. TREATMENT: Laryngospasm was aborted with assisted ventilation with oxygen 100% via bag and mask. OUTCOME: Oxygenation was well maintained with nasal prongs only postoperatively and haemoptysis resolved after 2 days. CONCLUSION: It is imperative to prevent laryngospasm from occurring and swift action must be taken to avoid pulmonary haemorrhage.- - - - - - - - - - ranking = 0.25keywords = anaesthesia (Clic here for more details about this article) |
5/7. Haemoptysis following insertion of a Swan-Ganz catheter.Haemoptysis occurred in a patient in whom a Swan-Ganz catheter was inserted for the induction of anaesthesia for hemicolectomy. It is suggested that acute pulmonary hypertension, superimposed on existing chronic pulmonary hypertension, superimposed on existing chronic pulmonary hypertension associated with mitral stenosis, was an important aetiological factor in the haemoptysis.- - - - - - - - - - ranking = 0.25keywords = anaesthesia (Clic here for more details about this article) |
6/7. Negative pressure induced airway and pulmonary injury.PURPOSE: To describe negative pressure injury occurring during the use of a laryngeal mask airway (LMA) in which airway bleeding rather than pulmonary oedema was the major complication. CLINICAL FEATURES: A patient presented to the day surgery unit for resection of a ganglion cyst on her right wrist. She underwent general anaesthesia using an LMA, and experienced severe laryngospasm and transient hypoxaemia (oxygen saturation to 66%) seven minutes after incision. This resolved within 90 sec of succinylcholine administration. Nonetheless, the LMA was removed, a tracheal tube was inserted atraumatically and positive pressure ventilation was maintained until the time of emergence, when fresh blood appeared in the tracheal tube. The blood ultimately became frothy, resembling pulmonary oedema fluid. Haemoptysis, continued postoperatively and led to the hospitalization of this ambulatory patient. CONCLUSION: Rapid development of large subatmospheric pressures, as can occur during severe laryngospasm, may disrupt the tracheobronchial vasculature causing airway bleeding. This bleeding should be distinguished from negative pressure pulmonary oedema.- - - - - - - - - - ranking = 0.25keywords = anaesthesia (Clic here for more details about this article) |
7/7. leeches in the larynx.This is a report of two patients with leech inhalation. The first patient presented with severe attacks of inspiratory stridor, cyanosis and cough of five days duration. He had no fever. Indirect laryngoscopy revealed a black, smooth foreign body between the vocal folds. Lateral soft tissue X-ray of the neck revealed shadow involving the glottic and the subglottic areas of the larynx. laryngoscopy under general anaesthesia showed a living leech. This was removed and the patient improved. The second patient presented with difficulty of breathing, dysphagia, and spitting of blood of two weeks duration. Indirect laryngoscopy revealed a brown foreign body in the larynx. laryngoscopy under general anaesthesia showed a living leech. This was removed by forceps.- - - - - - - - - - ranking = 0.5keywords = anaesthesia (Clic here for more details about this article) |