Transfusion-related acute lung injury and treatment with high-flow oxygen therapy in a pediatric patient: a case report

Transfusion-Related Acute Lung Injury (TRALI) is an immune-inflammatory lung pathology that manifests within the first 6–72 hours after administration of blood products. However, due to reduced awareness of TRALI, it continues to be an underreported and often underdiagnosed complication of transfusion therapy. We report a case of a 6-year-old girl with myelodysplastic syndrome and TRALI developed in the first hour after platelet transfusion. Diagnosis of TRALI is based on the exclusion of etiologic factors such as volume overload and cardiogenic pulmonary edema following transfusion. Symptoms responded to high-flow oxygen therapy, so intubation was not attempted and full recovery was achieved. © 2021 Sociedade Brasileira de AnestesiologiaThis Article was presented as an oral presentation at the 22nd International Intensive Care Symposium in Istanbul-Turkey on May 03-04, 2019

Influence of stroke volume variation on fluid treatment and postoperative complications in thoracic surgery

Cengiz Sahutoglu, Erbil Turksal, Seden Kocabas, Fatma Zekiye Askar Department of Anesthesiology and Reanimation, Ege University School of Medicine, Izmir, Turkey Background: Fluid management in critically ill patients usually relies on increasing preload to augment cardiac output. In the present study, we aimed to evaluate whether stroke volume variation (SVV) can guide fluid therapy and reduce complications.Patients and methods: In this retrospective study, a total of 88 patients who underwent lobectomy were divided into two groups: group 1 (SVV, n=43) and group 2 (conventional or central venous pressure [CVP], n=45). Heart rate, blood pressure, oxygen saturation, SVV (only group 1), CVP (all patients), urea, creatinine, and hemoglobin levels before and after surgery, use of fluid, blood and inotropic agents, and postoperative complications were recorded retrospectively.Results: The mean age of the study population was 56.9±14.4 years and 75% of the patients were male. SVV was used in fluid therapy in 48.9% of the patients. The use of SVV resulted in an increased use of crystalloids and colloids with increased urine output per hour (p<0.05). Of patients in the SVV group and the CVP group, 44.1% and 51.1% developed at least one complication, respectively (p=0.531). The rate of respiratory complications including atelectasis, pneumonia, hypoxemia, and an increased production of secretions was 21% in the SVV group and 37.7% in the CVP group (p=0.104). The rate of complications and the length of hospital stay were comparable between the groups (p>0.05).Conclusion: Our study results showed that the use of SVV increased the use of crystalloids and colloids and favorably affected urine output per hour but did not reduce complications in thoracic surgery. Keywords: central venous pressure, fluid management, lobectomy, one-lung ventilation, stroke volume variatio

Tramadol use in a patient with Brugada syndrome and morphine allergy: a case report

Cengiz Sahutoglu, Seden Kocabas, Fatma Zekiye Askar Ege University School of Medicine, Department of Anesthesiology and Reanimation, Izmir, Turkey Abstract: Brugada syndrome is a rare syndrome characterized by arrhythmias and sudden death, particularly in younger individuals. A mutation in a gene encoding the human cardiac sodium channels is responsible for this syndrome. In the literature, there are several case reports of Brugada syndrome in association with the use of several anesthetic agents. Herein, we present our anesthetic practice and the use of tramadol in a 75-year-old female patient who underwent pulmonary lobectomy under general anesthesia and was diagnosed with Brugada syndrome. Keywords: Brugada syndrome, tramadol, arrhythmia, analgesia, general anesthesia, postoperative complications, cardiac conduction defec

THE PREDICTIVE VALUE OF BRAIN ARREST NEUROLOGICAL OUTCOME SCALE ON MORTALITY AFTER CARDIAC ARREST

23rd Annual Meeting of the European-Society-of-Intensive-Care-Medicine -- OCT 09-13, 2010 -- Barcelona, SPAINWOS: 000281679500849European Soc Intens Care Me

Preoperative autologous donation in a pediatric patient undergoing open heart surgery [Acik kalp cerrahisi uygulanan pediyatrik hastada preoperatif otolog donasyon]

Preoperative Autologous Donation in a Pediatric Patient Undergoing Open Heart Surgery Pediatric open heart surgery is a major procedure in which transfusion rates are moderately high and blood products are mandatorily used during cardiopulmonary' bypass. Insufficiency of cross-match compatible blood products are rarely seen and these circumstances led to postponement of elective operations. Enforcement of blood preservation methods like preoperative autologous donation are necessary in these patients. In this article, we present, the case of a patient who had undergone surgery for the repair of congenital mitral valve insufficiency, in whom preoperative auotologous donation was performed because of lack of cross-match compatible blood products

Treatment of Pump Thrombosis With Low Dose Thrombolytic Therapy in Heartware HVAD Left Ventricular Assist Devices: Single Center Experience

38th Annual Meeting and Scientific Sessions of the International-Society-for-Heart-and-Lung-Transplantation (ISHLT) -- APR 11-14, 2018 -- Nice, FRANCEWOS: 000429934300132Int Soc Heart & Lung Transplanta

Heartmate 3 versus Heartmate 2: Is New Always Better ?

38th Annual Meeting and Scientific Sessions of the International-Society-for-Heart-and-Lung-Transplantation (ISHLT) -- APR 11-14, 2018 -- Nice, FRANCEWOS: 000430727300080Int Soc Heart & Lung Transplanta

Short-term Results of Heartmate 3 Ventricular Assist Device Implantation for End-Stage Heart Failure

WOS: 000398017900044PubMed ID: 28340840Objective. To report our initial experience with Heartmate 3 ventricular assist device (HM3) in cases with end-stage heart failure (ESHF). Methods. Charts of 8 ESHF patients who underwent HM3 implantation in our clinic from January to June 2016 (group 1) and 16 patients who underwent HM2 implantation during 2015 (group 2) were reviewed retrospectively. Demographics as well as pre and early postoperative medical data were noted and statistically analyzed between the 2 groups. Results. No statistical difference was found in age or sex distribution between groups (P >.05). Mean Interagency Registry for Mechanically Assisted Circulatory Support scores were 2.13 +/- 0.99 and 3.38 +/- 0.72 in groups 1 and 2, respectively (P =.020). Mean cardiopulmonary bypass time, and chest tube drainage fluid volume and blood product requirement during intensive care unit (ICU) stay were 64.0 +/- 13.9 minutes, 1,112.5 +/- 516.7 mL, and 318.8 +/- 271.2 mL, respectively, in group 1 and 89.0 +/- 33.3 minutes, 2,081.3 +/- 1,696.0 mL, and 1,118.8 +/- 1,010.8 mL in group 2 (P =.027, P =.019, and P =.040, respectively). Need for surgical revision and early mortality were not evident for group 1, although 4 cases (25.0%) required revision surgery, and early mortality was seen in 3 cases (18.8%) in group 2 (P =.121 and P =.190, respectively). Mean durations of ICU stay and total postoperative hospitalization were 5.9 +/- 2.0 and 18.3 +/- 5.5 days, respectively in group 1 and 6.2 +/- 4.3 and 18.0 +/- 6.9 days in the surviving 13 patients of the group 2 (P =.645 and P =.697, respectively). Conclusions. With its shorter implantation time and reduced blood product requirement in the early postoperative period, the HM3 system was found to be safe and effective in ESHF treatment