Cases reported "Hypotension"

Filter by keywords:



Filtering documents. Please wait...

1/134. Unusual cause of intraoperative hypotension diagnosed with transoesophageal echocardiography in a patient with renal cell carcinoma.

    Transoesophageal echocardiography (TOE) is not commonly used in the management of non-cardiac cases. We report a case where the use of TOE played a major role in the intraoperative diagnosis and subsequent management of a patient exhibiting severe hypotension whilst undergoing a nephrectomy. The rare diagnosis of a secondary intraventricular tumour would not have been evident with more conventional monitoring techniques.
- - - - - - - - - -
ranking = 1
keywords = operative
(Clic here for more details about this article)

2/134. Fatal cardiac ischaemia associated with prolonged desflurane anaesthesia and administration of exogenous catecholamines.

    PURPOSE: Four cardiac ischaemic events are reported during and after prolonged anaesthesia with desflurane. CLINICAL FEATURES: We have evaluated desflurane in 21 consecutive patients undergoing advanced head and neck reconstructive surgery. Four deaths occurred which were associated with cardiac ischaemic syndromes either during or immediately after operation. All patients in the study received a similar anaesthetic. This comprised induction with propofol and maintenance with alfentanil and desflurane in oxygen-enriched air. Inotropic support (either dopamine or dobutamine in low dose, 5 micrograms.kg.min-1) was provided as part of the anaesthetic technique in all patients. Critical cardiovascular incidents were observed in each of the four patients during surgery. These were either sudden bradycardia or tachycardia associated with ST-segment electrocardiographic changes. The four patients who died had a documented past history of coronary heart disease and were classified American Society of Anesthesiologists (ASA) II or III. One patient (#2) did not survive anaesthesia and surgery and the three others died on the first, second and twelfth postoperative days. Enzyme increases (CK/CK-MB) were available in three patients and confirmed myocardial ischaemia. CONCLUSION: These cases represent an unexpected increase in the immediate postoperative mortality for these types of patients and this anaesthetic sequence.
- - - - - - - - - -
ranking = 0.4
keywords = operative
(Clic here for more details about this article)

3/134. Pneumoencephalus and convulsions after ventriculoscopy: a potentially catastrophic complication.

    A nine-year-old boy with hydrocephalus underwent ventriculoscopy under general anesthesia. After introduction of ventriculoscope the patient had sudden bradycardia, hypotension, and shrinkage of ipsilateral cerebral hemisphere. The ventriculostomy was abandoned. At the end of anesthesia and endotracheal extubation, the patient developed generalized convulsions. Reexploration of wound did not reveal anything significant; however, postoperative CT scan of head showed massive pneumoencephalus. The patients received elective ventilation of lungs for 24 hours and made complete recovery. The authors describe the reasons for these complications and further management.
- - - - - - - - - -
ranking = 0.2
keywords = operative
(Clic here for more details about this article)

4/134. hypotension and adrenal insufficiency.

    This case conference describes two patients with hypotension who eventually were diagnosed with adrenal insufficiency. The first patient was initially believed to have a cardiac abnormality and the second patient sepsis, which was causing the continued hypotension. Both patients exhibited several clinical similarities; however, neither had the classic symptoms of adrenal insufficiency. This report discusses the causes of postoperative hypotension, diagnostic testing, and treatment for patients with adrenal insufficiency, and briefly reviews the literature.
- - - - - - - - - -
ranking = 0.2
keywords = operative
(Clic here for more details about this article)

5/134. splenic rupture associated with severe preeclampsia. A case report.

    BACKGROUND: splenic rupture is a very rare event complicating pregnancy. Approximately 5% of cases reported have involved the postpartum period. Unrecognized, this complication is universally fatal. CASE: Preeclampsia and pulmonary edema complicated a 42-year-old woman's intrapartum care. After cesarean delivery she was supported with mechanical ventilation, blood products and invasive monitoring. Shortly thereafter, she became hypotensive and developed disseminated intravascular coagulation. During exploratory laparotomy a splenic capsular rupture was identified. splenectomy and continued intensive care support ultimately reversed the severe end-organ consequences. CONCLUSION: It is extremely important that this condition be maintained in the diagnostic differential of post-operative hemodynamic instability. Failure to identify it is invariably fatal. awareness and intervention are essential to ensure a good outcome.
- - - - - - - - - -
ranking = 0.2
keywords = operative
(Clic here for more details about this article)

6/134. Management of peri-operative pulmonary hypertension in a patient presenting for a portosystemic shunt.

    We report the successful management of intra-operative pulmonary hypertension in a patient with mitral valve insufficiency and portal hypertension. A 48-year-old male with portal hypertension presented for a portosystemic shunt. Previously undiagnosed mitral valve insufficiency and pulmonary hypertension complicated his anaesthetic management. His intra-operative course was marked by systolic hypotension, pulmonary hypertension and a reduction in cardiac output. The use of nitric oxide in this patient reduced right ventricular afterload, increased cardiac output, without exacerbating pre-existing systolic hypotension.
- - - - - - - - - -
ranking = 1.2
keywords = operative
(Clic here for more details about this article)

7/134. Intraoperative cardiac arrest in a neurosurgical patient: what are the options?

    Intraoperative cardiac arrest is uncommon. We describe a case of intraoperative cardiac arrest in a patient undergoing anesthesia for surgical repair of an intracranial arteriovenous malformation (AVM).
- - - - - - - - - -
ranking = 1.2
keywords = operative
(Clic here for more details about this article)

8/134. Catecholamine dependency in a polytrauma patient: relative adrenal insufficiency?

    A 65-year-old polytrauma patient was admitted post-operatively to the intensive care unit. His situation deteriorated with hemodynamic instability and continuous high fever. An infectious focus could not be found and repeated cultures remained negative. Empirical administration of antibiotics and changing of lines did not have any effect on the clinical picture. It was impossible to lower the dose of catecholamines because of repeated occurrence of hypotension, despite optimal hydration state and filling pressures. On the 15th day of admission intravenous hydrocortisone was started on suspicion of relative adrenal insufficiency. This action resulted in rapid hemodynamic recovery, disappearance of fever and enabled rapid tapering of the dose of noradrenaline. incidence of relative adrenal insufficiency and diagnostic strategies are discussed in the population of critically intensive care patients.
- - - - - - - - - -
ranking = 0.2
keywords = operative
(Clic here for more details about this article)

9/134. Acute adrenal insufficiency after cardiac surgery.

    adrenal insufficiency after cardiac surgery can easily be confused during the course of an immediate unstable postoperative period. If unrecognized, this condition may cause serious morbidity and can be fatal. We report on a 43-yr-old female patient with chronic known adrenal insufficiency, who, despite her adequate preoperative replacement therapy, presented with one episode of acute hypoadrenal crisis after elective open heart surgery, which could serve as a model to illustrate the salient clinical features and possible problems in this setting for diagnosing this problem to patients in whom chronic adrenal insufficiency remains unknown.
- - - - - - - - - -
ranking = 0.4
keywords = operative
(Clic here for more details about this article)

10/134. Post-operative bilateral vision loss.

    A 41-year-old man presented with acute bilateral loss of vision upon awakening after elective surgery. After thorough evaluation it was determined that he had suffered bilateral posterior ischemic optic neuropathies secondary to hypotension while under general anesthesia. One eye showed significant improvement over the next 4 weeks, whereas the other remained unchanged.
- - - - - - - - - -
ranking = 0.8
keywords = operative
(Clic here for more details about this article)
| Next ->


Leave a message about 'Hypotension'


We do not evaluate or guarantee the accuracy of any content in this site. Click here for the full disclaimer.