1/4. life threatening complication of high-frequency jet ventilation.high-frequency jet ventilation is being increasingly used as an alternative to conventional methods of ventilation in both anaesthesia and intensive care. We report a case of severe respiratory obstruction as a complication of high-frequency jet ventilation. patients with bleeding diathesis, including patients on haemodialysis, may particularly be at risk.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
2/4. lens subluxation in homocystinuria. A case report.A 6-year-old girl had bilaterally subluxated lenses and liver and platelet dysfunctions. A cyanide-nitroprusside test of the urine was positive. serum and urinary levels of methionine and homocystine were high. cystathionine synthetase activity in the cultured skin fibroblasts was negligible. pyridoxine, 1000 mg/day orally, normalized the serum and urinary methionine and homocystine levels and the liver and platelet functions. Episodes of pupillary block glaucoma prompted lens extraction. The subluxated lenses were extracted under general anaesthesia after administration of pyridoxine and dextran to avoid thrombosis. A good result without serious complications was obtained. We believe that homocystinuria should not be considered a contra-indication to general anaesthesia. In the pyridoxine-responsive patient general anaesthesia is not hazardous if platelet function can be controlled by the vitamin.- - - - - - - - - - ranking = 3keywords = anaesthesia (Clic here for more details about this article) |
3/4. Spinal subdural bleeding after attempted epidural and subsequent spinal anaesthesia in a patient on thromboprophylaxis with low molecular weight heparin.Despite the extensive use of low molecular weight heparins (LMWH) for thromboprophylaxis, only two serious complications have thus far been reported where spinal haematomas were incurred after epidural and spinal blocks in patients on such treatment. In our patient, who was on thromboprophylaxis with the LMWH drug enoxaparin, catheter epidural anaesthesia was abandoned due to a bloody tap and superseded by spinal anaesthesia. More than 40 hours later she had developed a paraparesis and complete sensory loss in the lower extremities. The MRT image showed haematomas epi- and subdurally, as well as subarachnoidally, but no epidural bleeding was seen at laminectomy.- - - - - - - - - - ranking = 6keywords = anaesthesia (Clic here for more details about this article) |
4/4. Acute airway obstruction in a child with acute lymphoblastic leukaemia during central venous catheterization.We report the case of a seven-year-old girl with recently diagnosed acute lymphoblastic leukaemia (ALL) who suffered acute airway obstruction during insertion of a central venous catheter under general anaesthesia. The central airway obstruction was due to a mixture of leukaemic cells, blood clot and fibrin. There is discussion about airway obstruction both as a complication of central line insertion and secondary to ALL. The pulmonary complications of ALL, with particular reference to pulmonary haemorrhage, are detailed. The management of blood clot obstructing the central airway is discussed.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |