Filter by keywords:



Filtering documents. Please wait...

11/62. pleural effusion caused by prostaglandin E1 preparation.

    We encountered a case of bilateral pleural effusion associated with prostaglandin E(1) (PGE(1)) preparation. A 75-year-old man underwent replacement surgery for an amputated hand. PGE(1) was administered at 120 micro g/d to maintain circulation after vascularization. From day 7 of administration, respiratory distress developed. On day 12, pleural effusion was observed bilaterally. By discontinuing PGE(1) and improving hypoalbuminemia, pleural effusion resolved rapidly. This is the first case report of PGE(1)-induced pleural effusion; like other drug-induced pleural effusions, discontinuing the drug resulted in rapid improvement. Although a rare complication, pleural effusion has to be suspected when a patient receiving PGE(1) experiences difficulty with breathing.
- - - - - - - - - -
ranking = 1
keywords = breathing
(Clic here for more details about this article)

12/62. A case of difficult airway due to lingual tonsillar hypertrophy in a patient with Down's syndrome.

    In this report, we describe airway management of symptomatic lingual tonsillar hypertrophy in a pediatric patient with Down's syndrome. Besides obstructive sleep apnea, the history included a small atrial septal defect with mild aortic regurgitation and moyamoya disease. anesthesia was induced with IV administration of 1 mg/kg of propofol, followed by inhalation of sevoflurane in 100% oxygen. Muscle relaxants were not used on induction. Rigid laryngoscopy could not visualize the epiglottis because of hypertrophied tonsillar tissue, and mask ventilation became difficult when spontaneous breathing stopped. We avoided using a laryngeal mask airway because of a slight bleeding tendency presumably caused by preoperative antiplatelet therapy. Fiberoptic bronchoscopy through the nasal cavity in combination with jet ventilation successfully identified the glottis and allowed nasotracheal intubation to be accomplished. After lingual tonsillectomy, the patient was extubated on the seventh postoperative day, after supraglottic edema had resolved. Fiberoptic nasotracheal intubation under inhaled anesthesia may therefore be preferable in pediatric or uncooperative patients with symptomatic lingual tonsillar hypertrophy.
- - - - - - - - - -
ranking = 1
keywords = breathing
(Clic here for more details about this article)

13/62. Vascularized hemitracheal autograft for laryngotracheal reconstruction: a new surgical technique based on the thyroid gland as a vascular carrier.

    BACKGROUND: The management of extensive laryngotracheal stenosis has been a challenge confronting head and neck surgeons for over a century. The key to the successful restoration of a stable airway is providing a cartilaginous infrastructure to provide support to withstand both the negative and positive lumenal pressures produced during normal respiration and deglutition. We introduce a novel technique for restoration of such defects. methods: The blood supply to the thyroid gland by way of the inferior thyroid artery and the superior thyroid artery and vein are mobilized for transfer. One half to two thirds of the circumference of the adjacent tracheal rings are mobilized on the basis of the requirements of the stenotic segment. This mucochondrial composite tracheal flap is advanced superiorly to the ipsilateral "laryngeal" region where insetting of the cartilage and the mucosa is performed. Primary reconstruction or, more likely, a staged repair of the secondary tracheal defect is performed. RESULTS: Three case reports are presented. The patients were successfully decannulated postoperatively, continue to have an adequate voice, and are tolerating a diet (3-27 months postreconstruction). CONCLUSION: A new surgical technique for reconstruction of benign laryngotracheal stenoses is introduced to restore phonatory capability and a stable airway. The composite thyroid-tracheal graft based on the inferior and superior thyroid arterial pedicles allows a single-staged, primary reconstruction of the hemilarynx with a well-vascularized composite thyrotracheal flap that allows resurfacing as well as replacement of the infrastructure of the glottis and subglottis. This technique would be an excellent method to restore the cricoid ring following partial resection for primary cartilaginous tumors.
- - - - - - - - - -
ranking = 2.5287548728514
keywords = respiration
(Clic here for more details about this article)

14/62. phrenic nerve pacing in two young quadriplegic ventilator-dependent patients.

    patients who survive high cervical injury are usually dependent on mechanical ventilation and tracheostomy if the lesion above C3 is complete. We report our experience with phrenic nerve pacing (PNP) to achieve ventilator-independence in two young quadriplegic patients. A diaphragm conditioning programme, and combination of low frequency electrophrenic stimulation within each inspiratory burst and low breathing frequency enabled both patients initially to achieve continuous 24 hour ventilation independent of mechanical ventilation. One patient reverted to overnight mechanical ventilation (six hours) after three years. PNP should be considered in ventilator dependent patients with high cervical injury to achieve independence and improve quality of life.
- - - - - - - - - -
ranking = 1
keywords = breathing
(Clic here for more details about this article)

15/62. dysarthria and dysphagia as long-term sequelae in a child treated for posterior fossa tumour.

    The current case report provides a comprehensive description of the persistent dysarthria and dysphagia evident in a 7.5 year old child treated for recurrent posterior fossa tumour (PFT). AC was assessed on a comprehensive perceptual and instrumental test battery incorporating all components of the speech production system (respiration, phonation, resonance, articulation and prosody) 2 years and 4 months following completion of her treatment. The nature of her swallowing impairment was investigated through the use of videofluoroscopic evaluation of swallowing (VFS). A mild dysarthria with ataxic and LMN components was identified, although overall speech intelligibility was not affected. A moderate dysphagia was also identified with impairment in all three phases of the swallowing process; oral preparatory, oral and pharyngeal. dysarthria and dysphagia as persistent sequelae in children treated for PFT have implications for the long-term management of these children. The need for appropriate treatment regimes, as well as pre-surgical counselling regarding dysarthria and dysphagia as possible outcomes following surgery are highlighted.
- - - - - - - - - -
ranking = 2.5287548728514
keywords = respiration
(Clic here for more details about this article)

16/62. The breathing hand: obstetric brachial plexopathy reinnervation from thoracic roots?

    It has been found that in cases of obstetric brachial plexopathy, injured phrenic nerve or C3/4/5 roots may sprout into the adjacent injured upper and middle trunks of the brachial plexus. This aberrant regeneration produces co-contraction of the diaphragm and proximal upper limb muscles. This phenomenon, referred to as respiratory synkinesis or "the breathing arm", may not be limited to the upper cervical roots. We present two cases, identified through electromyographic investigations, of respiratory synkinesis selectively affecting intrinsic hand muscles, and propose that upper thoracic roots and their intercostal nerves may also produce respiratory synkinesis, resulting in a "breathing hand." This novel brand of synkinesis indicates that obstetric brachial plexus neuropathies can have quite proximal nerve injury in all trunks. The findings in our patients may not be entirely unique. The time required to develop distal muscle synkinesis and the subtle nature of our findings may suggest that with time and the assistance of EMG the breathing hand may be more common. When considering brachial plexus surgery, the significance of respiratory synkinesis should not be overlooked as its presence indicates injury at a root or proximal trunk level and may come from either nerves destined for the diaphragm or for the intercostal muscles.
- - - - - - - - - -
ranking = 7
keywords = breathing
(Clic here for more details about this article)

17/62. Anesthetic management of lower tracheal reconstruction.

    We report a case of 26 years old man who presented with dyspnoea and stridor in the emergency room. He was diagnosed as a case of posttracheostomy lower tracheal stenosis and scheduled for lower tracheal reconstruction. Patient was intubated in the operating room while breathing spontaneously. Due to proximity of stenosis to carina, a portex microlaryngeal tube was used to ventilate left lung during the period of tracheal resection.
- - - - - - - - - -
ranking = 1
keywords = breathing
(Clic here for more details about this article)

18/62. Cerebellar haemorrhage and tension pneumocephalus after resection of a Pancoast tumour.

    We present an unusual case of cerebellar haemorrhage followed by tension pneumocephalus several days after thoracotomy for resection of a Pancoast tumour. The postoperative course of the 32-year-old patient was complicated by a cerebellar haemorrhage and hydrocephalus caused by compression of the fourth ventricle. Immediate surgical evacuation of the haemorrhage and placement of an external ventricular drain was performed. Respirator ventilation maintaining a continuous positive airway pressure was required. Following weaning and extubation the patient rapidly deteriorated and became comatose. A cranial CT scan revealed a dilated ventricular system filled with air, and air in the subarachnoid space. Recovery of consciousness was observed after aspiration of intracranial air through the ventricular drainage. Recurrent deterioration of consciousness after repeated air aspiration indicated rapid refilling of the ventricles with air.The patient underwent emergency surgical re-exploration of the thoracic resection cavity: dural lacerations of the cervico-thoracic nerve roots C8 and Th1 were identified. Subarachnoid-pleural fistula, cerebellar haemorrhage and tension pneumocephalus after discontinuation of continuous positive airway pressure respiration are unusual complications of thoracic surgery. We discuss the putative pathomechanisms and present a brief review of the literature.
- - - - - - - - - -
ranking = 2.5287548728514
keywords = respiration
(Clic here for more details about this article)

19/62. Internal mammary artery steal syndrome secondary to an anomalous lateral branch.

    A 53-year-old male who underwent three-vessel coronary artery bypass grafting had a left internal mammary artery (LIMA) graft to the left anterior descending artery (LAD) and saphenous venous grafts to right coronary artery (RCA) and left circumflex coronary artery. Four years after surgery, he developed exertion angina associated with upper body exercises and even deep breathing at times. Angiographic evaluation revealed an anomalous lateral internal thoracic artery with steal phenomenon documented by adenosine cardiolyte. Patient was successfully treated with transcutaneous steel coil embolization by closing the anomalous vessel. Repeat stress electrocardiogram did not show any signs of ischemia. This case report emphasizes the variability in internal mammary artery (IMA) anatomy and the need to completely ligate all the branches of internal mammary artery intraoperatively.
- - - - - - - - - -
ranking = 1
keywords = breathing
(Clic here for more details about this article)

20/62. Transient tetraplegia after cervical facet joint injection for chronic neck pain administered without imaging guidance.

    We report about a patient in whom transient tetraplegia with intact proprioception occurred immediately after infiltration of a facet joint at the C6 level guided by anatomical landmarks. After positioning the patient supine and applying atropine and oxygen, respiration and circulation were stable and all symptoms resolved within the next 30 min. The type of neurological pattern and the course of disease suggest an inadvertent injection into a cervical radicular artery that reinforces the anterior spinal artery. This complication is potentially serious and may be permanently disabling or life threatening. It should be considered by any clinician performing "blind" zygapophysial joint injections in the cervical spine. Using imaging guidance should help prevent this type of complication.
- - - - - - - - - -
ranking = 2.5287548728514
keywords = respiration
(Clic here for more details about this article)
<- Previous || Next ->


Leave a message about 'Postoperative Complications'


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