Sevoflurane induced diffuse alveolar haemorrhage in a young patient after orthopedic surgery: A case report

We present a very rare case of Sevoflurane Induced Diffuse Alveolar Haemorrhage in a young male patient with a closed tibial fracture after direct trauma to the right cruris. The patient was operated for tibial fracture, but diffuse alveolar haemorrhage developed after sevoflurane inhalation in the postoperative period following general anesthesia. Diffuse alveolar haemorrhage (DAH) is associated with inhalation injury from halogenated gases and reported as a unique entity in the literature that practicing clinicians should be aware of and consider in post-operative cases of acute respiratory distress. As DAH usually presents with symptoms the presence of hemoptysis, anemia, dyspnoea and radiological alveolar infiltrates, rapid detection of the aetiology and initiation of cause-directed treatment are of great importance on survival.
Source: Nigerian Journal of Clinical Practice - Category: Rural Health Authors: Source Type: research

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AbstractPurpose of ReviewThe purpose of this review is to assess how residual neuromuscular block impacts postoperative pulmonary complications and whether we can modify the risk by improving certain aspects in daily clinical care.Recent findingsPostoperative respiratory impairment may be due to various causes, such as age, surgery type, comorbidity, smoking, preoperative anemia, and general anesthesia. However, increasing evidence suggests that residual neuromuscular block is an important risk factor for postoperative pulmonary complications and may affect the outcome. Conflicting data from some recent reports show that t...
Source: Current Anesthesiology Reports - Category: Anesthesiology Source Type: research
We report the case of a 33-year-old patient who presented with dyspnea and hemoptysis due to an oropharyngeal leech infestation. The patient was a shepherd and his detailed history revealed that he had been drinking water from natural springs. In the examination, a vivid dark green colored foreign body moving towards the nasopharynx and hypopharynx was detected in the oropharynx. The leech was removed under local anesthesia by gently grasping with the help of a long clamp. It should be noted that leeches are common in rural water sources and they can cause severe morbidity and even mortalities due to serious complications ...
Source: Turkish Society for Parasitology - Category: Parasitology Authors: Tags: Turkiye Parazitol Derg Source Type: research
CONCLUSION: The large bias and the wide limits of agreement between Sp-Hb and Lab-Hb denote that Masimo-derived Sp-Hb is not accurate in children with congenital heart disease especially in the cyanotic group; the error in Sp-Hb increases when oxygen saturation decreases. PMID: 32160358 [PubMed - as supplied by publisher]
Source: Paediatric Anaesthesia - Category: Anesthesiology Authors: Tags: Paediatr Anaesth Source Type: research
This article provides practical information regarding the implementation of anemia management strategies in surgical patients throughout the perioperative period. This includes evidence-based recommendations for the prevention, diagnosis, and treatment of anemia, including the utility of iron supplementation and erythropoiesis-stimulating agents (ESAs). PMID: 32167979 [PubMed - as supplied by publisher]
Source: Anesthesia and Analgesia - Category: Anesthesiology Authors: Tags: Anesth Analg Source Type: research
Purpose of review Red cell transfusions are commonly used in management of hemorrhage in trauma patients. The appropriate indications and criteria for transfusion are still debated. Here, we summarize the recent findings on the use of red cell transfusion in trauma setting. Recent findings Recent evidence continues to support the long-established link between allogeneic transfusion and worse clinical outcomes, reinstating the importance of more judicious use of allogeneic blood and careful consideration of benefits versus risks when making transfusion decisions. Studies support restrictive transfusion strategies (ofte...
Source: Current Opinion in Anaesthesiology - Category: Anesthesiology Tags: TRAUMA AND TRANSFUSION: Edited by Andrea U. Steinbicker Source Type: research
Purpose of review Traumatic injury has been described as a growing pandemic which has significant implications for global health. In the trauma setting, anemia is a common occurrence and is frequently inadequately addressed. It is associated with significant morbidity and incurs great cost – both to the patient and to the health system. The cause is multifactorial, and the pathophysiology is incompletely understood. Appropriate care of the trauma patient is a multidisciplinary responsibility and a focused approach to anemia is vital. The recommendation for restrictive transfusion strategies and the potential benefi...
Source: Current Opinion in Anaesthesiology - Category: Anesthesiology Tags: TRAUMA AND TRANSFUSION: Edited by Andrea U. Steinbicker Source Type: research
We read with great interest the recent article entitled “Impact of Preoperative Iron Deficiency on Blood Transfusion in Elective Cardiac Surgery” published in the Journal of Cardiothoracic and Vascular Anesthesia.1 This prospective observational study aims at assessing the incidence of preoperative iron deficiency (ID) and ID anemia in patients under going elective cardiac surgery. As commonly accepted, ID was defined in this study by a serum ferritin level
Source: Journal of Cardiothoracic and Vascular Anesthesia - Category: Anesthesiology Authors: Tags: Letter to the Editor Source Type: research
Conclusions Adult patients undergoing noncardiac surgery demonstrate varying associations with distinct levels of hypotension when stratified by preoperative risk factors. Specific levels of absolute hypotension, but not relative hypotension, are an important independent risk factor for acute kidney injury.Editor ’s PerspectiveWhat We Already Know about This TopicAcute kidney injury occurs in 13% of patients undergoing major surgery and is associated with a six-fold increased risk of mortality.Single-center studies have demonstrated an association between intraoperative hypotension and acute kidney injury.What This A...
Source: Anesthesiology - Category: Anesthesiology Source Type: research
We present a process map for the implementation of a program to treat preoperative anemia utilizing 1 existing anesthesiologist in the preoperative evaluation clinic. In the first 7 months postimplementation, 342 patients were screened for anemia, 166 were diagnosed, and 107 were treated. The mean increase in hemoglobin in treated patients was ~2 g/dL (range 0–4.9 g/dL). Two patients’ surgeries were delayed in favor of treatment and 3 surgical patients, who had received 2 complete iron infusions, received an intraoperative transfusion. The total revenue generated for the institution was enough to ...
Source: A&A Case Reports - Category: Anesthesiology Tags: Innovation Source Type: research
The objective of this study was to develop a risk stratification index (RSI) system to guide intensive care unit (ICU) resource use for elderly patients after hip fracture surgery. The authors' first study cohort consisted of 302 elderly patients with hip fractures who had surgical treatment at their hospital. The authors conducted multivariate logistic regression analysis to investigate relevant risk factors for ICU resource utilization postoperatively. An RSI system was developed based on the significant risk factors from regression analysis. A second study cohort consisted of 205 elderly patients, among whom the authors...
Source: Orthopedics - Category: Orthopaedics Authors: Tags: Orthopedics Source Type: research
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