Full recovery after cardiopulmonary resuscitation in lateral position necessitated by hemorrhagic shock

 Introduction: Cardiac arrest during general anesthesia is often witnessed and anticipated with better prognosis. But it may have some difficulties as positions other than supine. Case Presentation: A 43-year-old woman underwent a left radical nephrectomy due to renal cancer while in a lateral position. Her operation was complicated by massive bleeding because of a laceration in the inferior vena cava. Due to rapid blood loss, pulseless electrical activity occurred. Chest compressions were administered with the patient in the lateral decubitus position. Following a blood transfusion, IV fluid administration, FFP, induced hypothermia, fresh whole blood and norepinephrine infusion, the patient was stabilized. She was transferred to ICU, and after 24 hours she was extubated. The next week she was discharged with no neurological damage. Conclusion: Initiating chest compressions as soon as possible even in positions other than supine could minimize hypoxic complications and enhance prognosis of cardiac arrest.

Comparative evaluation of intra-cuff ropivacaine, bupivacaine, and lidocaine on emergence reactions after general anesthesia

Background: Emergence reactions are common after general anesthesia with tracheal intubation and can beassociated with severe hemodynamic consequences. Inflating the cuff with local anesthetic instead of air has been reported to prevent these problems. However, no definitive results have been obtained for the effectiveness of this method. This study tried to come to a more reasonable conclusion by conducting more studies, and we used a variety of local anesthetics.Materials and Methods: This study was performed on 350 patients over 18 years undergoing general anesthesia using an endotracheal tube. Patients were divided into five groups based on endotracheal tube cuff inflation with lidocaine, ropivacaine, bupivacaine, isotonic saline, and air. After removing the endotracheal tube, patients were evaluated for cough, sore throat, and hoarseness.Results: Cough, sore throat, and hoarseness were observed in 43.7%, 27.4%, and 4.6% of cases, respectively.At all measured times, all reactions in all local anesthetic groups were weaker than in the air and saline groups.The difference between the local anesthetic groups was not significant.Conclusion: Using local anesthetics to inflate the endotracheal cuff reduces the incidence of emergencereactions from general anesthesia

Anesthetic consideration of Niemann-Pick Disease type C

Nieman-Pick disease type C is a rare, autosomal recessive, neurometabolic disorder associated with the accumulation of unesterified cholesterol in lysosomes and late endosomes. Because of multiple organ involvement and wide range of clinical manifestations, these patients will demand multiple diagnostic and therapeutic procedures requiring anesthesia. Sincepathogenesis of this disease is still unknown, further investigations on cellular and molecular basis of NPC is needed. In this report we present a known case of NPC1 requiring anesthesia for Percutaneous Endoscopic Gastrostomy and a brief review about molecular basis and recent advances in this field. 

Management of Alveolar Proteinosis by Bronchopulmonary lavage under Extra Corporeal Membrane Oxygenation (ECMO)

The gold standard of treating Pulmonary Alveolar Proteinosis (PAP) is bronchopulmonary lavage (BPL). We describe a rare case of BPD for PAP, who underwent extracorporeal membrane oxygenation (ECMO) due to hypoventilation in the setting of one-lung ventilation. First, the clinical course of the patient is presented; furthermore, the biomolecular basis of PAP and new treatment approaches is discussed. &nbsp

DIDMOAD (Wolfram) Syndrome

Wolfram syndrome was first described by physician D J Wolfram and Wagener in 1938. This autosomal recessive syndrome is also referred to as DIDMOAD syndrome which stands for Diabetes Insipidus, Insulin Dependent Diabetes Mellitus, Optic Atrophy and Deafnes

Anesthetic Management in Tibial Fracture of a Known Case of Wolfram Syndrome

Wolfram syndrome is a rare progressive disease with diabetes insipidus, diabetes mellitus, optic atrophy, and deafness (DIDMOAD). Furthermore, other comorbidities and manifestations accompany this disease. Anesthetic management may be challenging in these cases and need special consideration due to present symptoms, disabilities, and comorbidities. This report presents anesthetic management of a traumatic patient with Wolfram syndrome candidate for orthopedic surgery. The report also discusses manifestation and anesthetic consideration in this population

The Mortality Rate in COVID-19 Patients Undergoing Anesthesia for Surgical Procedures

Background: Planning anesthesia for coronavirus disease (COVID) positive patients remains a big dilemma for anesthesiologists. Aside associated harms of postponing surgeries, there is concern about the outcome of COVID after surgical stress, limitation of resources, and personal safety. Therefore, we aimed to investigate the effect of surgery and anesthesia on the course of coronavirus disease 2019 (COVID-19). Methods: A total of 179 patients (COVID-positive) who underwent surgery under anesthesia from March 2020 until March 2021 were retrospectively evaluated. The type of surgery, type of anesthesia, and outcome of patients were recorded. Renal and liver function tests as well as respiratory system function before and after surgery were compared. Results: Among them, 39 patients died (27%). Laboratory data including creatinine (Cr), Aspartate Transaminase (AST), Alanine Transaminase (ALT), Alkaline Phosphatase (ALK), and troponin were not significantly different preoperatively and post-operatively. 28 patients (15.6%) were intubated due to post-operative respiratory failure. In our study mortality rate for all types of surgery was 27% and the postoperative intubation rate was 15.6%. We did not have any organ failure after interventional procedures. Conclusion: The risk of infection progression must be weighed before scheduling invasive procedures. Moreover, regional anesthesia may be less harmful in case of urgent or emergent need for surgery in infected patients

Treacher Collins Syndrome; Anesthetic considerations and Molecular Findings

Treacher Collins Syndrome (TCS) is a rare disease with mandibulofacial dysostosis. The deformities accompanied by this syndrome could cause especial challenges for anesthesiologist. On the other hand Treacher protein is well recognized in the pathogenesis of this syndrome. In this report we want to present a successful management of a patient with Treacher Collins syndrome and also describe new advances in the molecular aspect of this disease

Supplemental Oxygen therapy and Non-Invasive Ventilation in Corona Virus Disease (COVID-19)

The world has experienced a pandemic due to novel Severe Acute Respiratory Disease Corona Virus-2 (SARS-CoV2) since December 2019. The clinical spectrum of the disease known as Coronavirus Disease 2019 (COVID-19) is so much wide, starting from an asymptomatic state to paucisymptomatic clinical presentation, pneumonia, respiratory failure to even death. Supplemental oxygen therapy is essential in managing COVID-19. Also, there is sparse evidence regarding use of non-invasive ventilation (NIV) in pandemics like SARS-CoV-2. This study reviews the currently available methods for respiratory support in COVID-19 with a discussion about using these modalieties in the COVID-19 pandemic