Thoracoscopic surgery under local anesthesia for high-risk intractable secondary spontaneous pneumothorax

ConclusionThoracoscopic surgery under local anesthesia can be the worthwhile definitive modality, among few remaining treatments, for highly fragile patients with SSP. Detecting air leakage directly and the presence of thin and transparent bullae without any other suspicious lesions can be clues for identifying culprit lesions.
Source: General Thoracic and Cardiovascular Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research

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Abstract Cannabis is now legalized, for medical and/or recreational use, in numerous states. Although the cultural shift in acceptance of cannabis is apparent in the public, that sentiment has not necessarily translated to healthcare professionals. As anesthesia providers, we must understand the pharmacology of cannabis and its effects on physiology to provide safe anesthetic care to patients who consume it. The purpose of this article is to describe cannabis and its pharmacologic and physiologic effects and to review the anesthetic implications of its short-term and long-term use. PMID: 32442102 [PubMed - as...
Source: AANA Journal - Category: Anesthesiology Authors: Tags: AANA J Source Type: research
Abstract Current criteria used to make the clinical diagnosis of fat embolism syndrome were never intended to be applied to an anesthetized, mechanically ventilated patient in the operating room and, as such, may not be applicable during intraoperative care. Because of this, confusion still exists among anesthesia providers in recognizing this potentially fatal clinical condition. Our goal was to develop and then present a more exacting and rigorous grading scale, tailored specifically for the anesthetized patient, with the hope that it will aid clinicians in recognizing and successfully managing the manifestation...
Source: AANA Journal - Category: Anesthesiology Authors: Tags: AANA J Source Type: research
This article addresses the need for a protocol by including occurrences of accidents and injuries, consequences to anesthesia practice and patient care, costs, and the culture in an anesthesia group or department. Components of the protocol are formation of a committee, risk assessment, clear workplace policy, annual continuing education, annual supervisor training, drug screening of anesthesia personnel, pharmacy accountability, and access to treatment. The article describes the protocol and provides supplemental information to aid in implementation at other anesthesia departments. Substance abuse among CRNAs is a complex...
Source: AANA Journal - Category: Anesthesiology Authors: Tags: AANA J Source Type: research
This article examines successful management of an anesthesia machine failure with the Draeger (or Dräger) Apollo (Draeger Inc) anesthesia workstation. Approximately 45 minutes into the case, while the patient was under general anesthesia and mechanical ventilation, the anesthesia machine failed to achieve positive pressurization following a high-pressure alarm. Despite multiple maneuvers, the issue did not resolve until the machine was manually powered off and on at the main power switch. This case report emphasizes the importance of always having a backup means of patient ventilation and anesthesia administration. ...
Source: AANA Journal - Category: Anesthesiology Authors: Tags: AANA J Source Type: research
Abstract Poor management of endotracheal tube cuff pressures occurs in more than 50% of all general anesthetics, leading to tracheal ischemia, tracheal rupture, sore throats, recurrent laryngeal nerve palsy, tracheal stenosis, microaspiration, and/or inadequate ventilation. General endotracheal anesthesia is common practice throughout the world. Endotracheal tube cuffs are filled with a fluid (gas or liquid) to a safe and adequate pressure of 20 to 30 cm H2O to protect the lung parenchyma from aspiration while also ensuring positive pressure can be generated to oxygenate/ventilate patients. An evidence-based proje...
Source: AANA Journal - Category: Anesthesiology Authors: Tags: AANA J Source Type: research
Abstract Nurse anesthesia programs are stressful, with routine information overload, immersion into new environments, and financial stressors. One strategy to combat this stress is to practice clinical skills in the less intimidating and safe environment of simulation. Evidence strongly suggests that simulation is an important component of a well-rounded nurse anesthesia program. However, no simulation literature was found to assist the transition of student registered nurse anesthetists (SRNAs) into their cardiac anesthesia rotations. The purpose of this evidence-based practice improvement project was to create a...
Source: AANA Journal - Category: Anesthesiology Authors: Tags: AANA J Source Type: research
This study was done to ascertain the optimum fresh gas flow (FGF) offering the best balance between rapid induction and minimal waste in pediatric patients. Forty-five children (weighing 10-20 kg) undergoing elective procedures under general anesthesia were randomly assigned into 3 groups: 0.5 minute ventilation (MV), MV, and S (FGF = 6 L/min). After priming the pediatric closed circuit, anesthesia was induced using a face mask with 8% sevoflurane in 100% oxygen (Draeger Primus Vista 120 anesthesia machine) at FGF-determined MV per group allocation. After loss of eyelash reflex (time 1 [T1]), intravenous cannulation (T2) a...
Source: AANA Journal - Category: Anesthesiology Authors: Tags: AANA J Source Type: research
Publication date: September 2020Source: Urology Case Reports, Volume 32Author(s): Alex Oserowsky, Devin Allison, Stephen Weinstein, Van Nguyen, Katie S. Murray
Source: Urology Case Reports - Category: Urology & Nephrology Source Type: research
Conclusion: Surgical biopsy provided definite diagnosis in 98% of our cases. However, the mortality was 6%. Therefore surgical biopsy decision should be considered multidisciplinary in appropriate patients.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: ILD/DPLD of known origin Source Type: research
ConclusionsAdditional intrathoracic findings are highly prevalent and significantly impact prognosis in patients with PE and cancer, making them germane to the classification of this population.
Source: Clinical and Translational Oncology - Category: Cancer & Oncology Source Type: research
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