Anesthesia Management in a Patient with Cystic Fibrosis (A Case Report)

Cystic fibrosis (CF) is a hereditary disease resulting from a chlorine channel defect with autosomal recessive transmission, a structural and functional disorder in the transport of chlorine (Cl) through the plasma membrane in epithelial cells in organs such as the lungs, pancreas, liver, intestines, sweat glands, and epididymis. The most affected regions are the lungs and the gastrointestinal system. These cases are important for their perioperative respiratory complications. We present an anesthesia method conducted on a 16-year-old female CF case receiving general anesthesia

Anesthesia Management in Robinow Syndrome (A Case Report)

Robinow Syndrome (RS) is a rare disease characterized by anomalies in the face, head, external reproductive organs, and spine segmentation. The three main symptoms of the syndrome are fetal face appearance, genital hypoplasia, and gingival hyperplasia. Fifteen percent of the cases have congenital heart defects. Short neck, large tongue, and airway problems due to a structural disorder of the face may be observed. In this paper, we present our anesthesia practice in a case that had been diagnosed with RS

Relationship of percutaneous tracheostomy timing with APACHE II and SOFA scores on the first day of ICU for critically ill patients

Objective: Our study aimed to assess the relation between APACHE II and SOFA scores of critically ill patients on their first day of admission and the timing of percutaneous dilatational tracheotomy (PDT).Methods: Following approval of the Ethics Board of Health Sciences University Istanbul Bağcılar Educational Research Hospital (25.08.2016-2016/495), data of all 91 patients who had been treated with PDT in the ICU between June 1, 2014 and June 1, 2016 have been retrospectively evaluated. We recorded the following information: demographical data (such as age, sex, body mass index) that could be obtained from patient records, APACHE II and SOFA scores on their first day in ICU, and PDT timing.Results: There was no statistically significant difference observed between the timing of the PDT and APACHE II and SOFA scores (p>0.05).Conclusion: Our results showed that most of the patients with PDT had an APACHE II score of 15-24. We noticed that the number of patients with an APACHE II score of 24 and higher was notably lower than the number of patients with scores between 15-24. The fact that the life expectancy for the patient group with a high APACHE II score is low may call the tracheostomy decision into question. On the other hand, no relation was found between differences in APACHE II and SOFA scores and the starting time of PDT

Use of Awake Flexible Fiberoptic Bronchoscopic Nasal Intubation in Secure Airway Management for Reconstructive Surgery in a Pediatric Patient with Burn Contracture of the Neck

Although the use of awake flexible fiberoptic bronchoscopic (FFB) intubation is a well-recognized airway management technique in patients with difficult airway, its use in smaller children with burn contractures or in an uncooperative older child may be challenging. Herein, we report successful management of difficult airway in a 7-year-old boy with burn contracture of the neck, by application of FFB nasal intubation in a stepwise approach, first during an initial preoperative trial phase to increase patient cooperation and then during anesthesia induction for the reconstructive surgery planned for burn scars and contractures. Our findings emphasize the importance of a preplanned algorithm for airway control in secure airway management and feasibility of awake FFB intubation in a pediatric patient with burn contracture of the neck during anesthesia induction for reconstructive surgery. Application of FFB intubation based on a stepwise approach including a trial phase prior to operation day seemed to increase the chance of a successful intubation in our patient in terms of technical expertise and increased patient cooperation and tolerance by enabling familiarity with the procedure

Continuous Endotracheal Tube Cuff Pressure Control Decreases Incidence of Ventilator-Associated Pneumonia in Patients with Traumatic Brain Injury

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Mild Hypothermia via External Cooling Improves Lung Function and Alleviates Pulmonary Inflammatory Response and Damage in Two-Hit Rabbit Model of Acute Lung Injury

Objectives Targeted temperature management (TTM) with therapeutic hypothermia (TH) has an organ-protective effect by mainly reducing inflammatory response. Here, our objective was to determine, for the first time, whether mild TH with external cooling, a simple and inexpensive method, could be safe or even beneficial in two-hit rabbit model of acute lung injury/acute respiratory distress syndrome (ALI/ARDS). Methods Twenty-two New Zealand rabbits (6-month-old) were randomly divided into healthy control (HC) with conventional ventilation, but without injury, model group (ALI), and hypothermia group with external cooling (ALI-HT). After induction of ALI/ARDS through mild lung-lavages followed by non-protective ventilation, mild hypothermia was started in ALI-HT group (body temperature of 33-34 degrees C). All rabbits were conventionally ventilated for an additional 6-h by recording respiratory parameters. Finally, lung histopathology and inflammatory response were evaluated. Results Hypothermia was associated with higher oxygen saturation, resulting in partial improvement in the P/F ratio (PaO2/FiO(2)), oxygenation index, mean airway pressure, and PaCO2, but did not affect lactate levels. The ALI-HT group had lower histopathological injury scores (hyperemia, edema, emphysema, atelectasis, and PMN infiltration). Further, tumor necrosis factor-alpha (TNF-alpha), interleukin (IL)-6 and -8 levels in lung tissue and serum samples markedly reduced due to hypothermia. Conclusion Mild TH with external cooling reduced lung inflammation and damage, whereas it resulted in partial improvement in gas exchanges. Our findings highlight that body temperature control may be a potentially supportive therapeutic option for regulating cytokine production and respiratory parameters in ALI/ARDS