Immediate reversal of clinically mute left-to-right shunt into life-threatening right-to-left shunt during positive pressure ventilation of an ASA II adult - a rare but possible cause of severe hypoxia during induction of anaesthesia

2012 ◽  
Vol 29 ◽  
pp. 57
Author(s):  
T. N. Napiorkowski ◽  
M. Symonides ◽  
D. Stanczewska ◽  
M. Lipiec
Keyword(s):  
Positive Pressure Ventilation ◽  
Severe Hypoxia ◽  
Positive Pressure ◽  
Life Threatening ◽  
Induction Of Anaesthesia ◽  
Possible Cause

scholarly journals Etorphine-Ketamine Constant Rate Infusion for Maintenance of Anaesthesia in a Compromised White Rhinoceros (Ceratotherium simum)

2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Friederike Pohlin ◽  
Peter Buss ◽  
Michele Miller ◽  
Gerhard Steenkamp ◽  
Robin Gleed ◽  
...  
Keyword(s):  
Intermittent Positive Pressure Ventilation ◽  
Positive Pressure ◽  
Constant Rate Infusion ◽  
Respiratory Impairment ◽  
Constant Rate ◽  
White Rhinoceros ◽  
Life Threatening ◽  
History Of ◽  
Induction Of Anaesthesia ◽  
Rate Infusion

A subadult white rhinoceros bull presented for oesophageal endoscopic evaluation and foreign body removal under general anaesthesia. The animal had a history of nasal and oral regurgitation of water and ingesta with weight-loss for 6 days prior to the procedure and had been diagnosed with oesophageal obstruction caused by a bailing wire. Anaesthesia was induced with intramuscular etorphine and azaperone delivered remotely by dart, followed by an intravenous bolus of ketamine. The trachea was intubated, and anaesthesia was maintained with an etorphine-ketamine constant rate infusion (CRI). The rhinoceros did not respond predictably to induction of anaesthesia and developed life-threatening systemic hypotension throughout the 90-minute procedure. A mega-vertebrate demand ventilator was successfully used to provide intermittent positive pressure ventilation when the rhinoceros developed apnoea. This case report describes the maintenance of anaesthesia of a white rhinoceros using an etorphine-ketamine CRI and the causes and management of hypotension and respiratory impairment observed in this patient.

scholarly journals Respiratory Management of Acute Cardiogenic Pulmonary Edema: A Review

2020 ◽  
Author(s):  
Khosro Barkhordari ◽  
Zahid Hussain Khan ◽  
Akbar Shafiee
Keyword(s):  
Pulmonary Edema ◽  
Positive Pressure Ventilation ◽  
Noninvasive Positive Pressure Ventilation ◽  
Cardiogenic Pulmonary Edema ◽  
Positive Pressure ◽  
Acute Cardiogenic Pulmonary Edema ◽  
Respiratory Management ◽  
Threatening Condition ◽  
Ventilator Management ◽  
Life Threatening

Acute cardiogenic pulmonary edema (ACPE) is a common and life-threatening condition among patients with heart failure. The literature contains a large number of reviews discussing the respiratory management aspect of this entity; nonetheless, none of these studies has thoroughly probed into the respiratory management of different cardiac pathologies ending with ACPE, together with the different modes of ventilation and invasive and noninvasive ventilation in the same discussion. The present review seeks to discuss the physiologic bases of lung-heart interactions, the hemodynamic effects of positive pressure ventilation, and the results of studies on the effects of the various modes of ventilation having been used until the writing of this article. Also discussed herein are ACPE in different heart pathologies and their respective ventilator management, as well as the indications, complications, and contraindications of noninvasive positive pressure ventilation and intermittent mandatory ventilation.

scholarly journals Non-Cardiogenic Pulmonary Oedema Following the Use of Gadolinium-Based Contrast Medium: A Case Report

2020 ◽  
Vol 6 (3) ◽  
pp. 181-185
Author(s):  
Chilan Nguyen ◽  
Tho Pham
Keyword(s):  
Pulmonary Oedema ◽  
Positive Pressure Ventilation ◽  
Rare Complication ◽  
Positive Pressure ◽  
Cardiogenic Pulmonary Oedema ◽  
Contrast Administration ◽  
Prompt Treatment ◽  
Appropriate Treatment ◽  
Life Threatening ◽  
Life Threatening Complication

AbstractNon-cardiogenic pulmonary oedema can be life threatening and requires prompt treatment. While gadolinium-based contrast is generally considered safe with a low risk of severe side effects, non-cardiogenic pulmonary oedema has become increasingly recognised as a rare, but possibly life-threatening complication. We present a case of a usually well, young 23-year-old female who developed non-cardiogenic pulmonary oedema with a moderate oxygenation impairment and no mucosal or cutaneous features of anaphylaxis following the administration of gadolinium-based contrast. She did not respond to treatment of anaphylaxis but made a rapid recovery following the commencement of positive pressure ventilation. Our case highlights the importance of recognising the rare complication of non-cardiogenic pulmonary oedema following gadolinium-based contrast administration in order to promptly implement the appropriate treatment.

scholarly journals Tracheal Diverticulum in SARS-CoV-2 Patients on Non-Invasive Ventilation A not so “Spontaneous” Cause of Pneumomediastinum? An imaging Pictorial Presentation of Two Cases with Review of Literature

2021 ◽  
Vol 28 (2) ◽  
pp. 19
Author(s):  
Veena Mariam Joseph ◽  
Donboklang Lynser ◽  
Iadarilang Tiewsoh ◽  
Kaustuv Dutta ◽  
Pranjal Phukan ◽  
...  
Keyword(s):  
Positive Pressure Ventilation ◽  
Positive Pressure ◽  
Non Invasive ◽  
Pictorial Presentation ◽  
Tracheal Diverticulum ◽  
Free Air ◽  
Non Invasive Ventilation ◽  
Threatening Condition ◽  
Life Threatening

Spontaneous pneumomediastinum is a rare but potentially life-threatening condition, the incidence of which has showed an increase in patients with SARS-CoV-2 pneumonia, especially when they are on positive pressure ventilation. None of the reported cases of covid related pneumomediastinum had an associated tracheal diverticulum. Also, to the best of our knowledge, tracheal diverticulum has not been reported in patients on NIV. We report 2 cases of COVID-19 pneumonia on NIV with pneumomediastinum, which also had associated tracheal diverticulum, one of which developed after NIV. Though the establishment of causality needs further research, early detection of a tracheal diverticulum, which might be a harbinger of pneumomediastinum, can be a timely alarm to prompt titration of the pressure settings and judicious use of NIV. The role of inverted grey scale CT images in mediastinal window is a simple, yet hardly utilised radiological tool to increase detection of ‘mediastinal air’, let it be free air or air within a diverticulum. Through this case report, we would like to highlight the role of conventional and inverted CT imaging of pneumomediastinum and tracheal diverticulum in general and in SARS-CoV-2 pneumonia in particular, and to call for more objective research to throw light on the plausible relationship between pneumomediastinum and tracheal diverticulum.

scholarly journals Traumatic occurrence of chest wall tamponade secondary to subcutaneous emphysema

CJEM ◽  
2008 ◽  
Vol 10 (04) ◽  
pp. 387-391 ◽  
Author(s):  
Michael Perraut ◽  
Daniel Gilday ◽  
Gordon Reed
Keyword(s):  
Respiratory Failure ◽  
Subcutaneous Emphysema ◽  
Unusual Case ◽  
Positive Pressure Ventilation ◽  
Tension Pneumothorax ◽  
Tube Placement ◽  
Positive Pressure ◽  
Management Options ◽  
Physical Finding ◽  
Life Threatening

ABSTRACTSubcutaneous emphysema is a physical finding that itself is usually perceived as benign yet rarely may, in and of itself, be life-threatening. We present an unusual case of a 67-year-old woman who developed delayed severe subcutaneous emphysema and tension pneumothorax from a rib fracture subsequent to a fall. We review the pathophysiology, manifestations and management options of this disorder. In patients whose clinical condition allows it, chest tube placement prior to intubation should be considered. Furthermore, positive end-expiratory pressure should be minimized. We present a case that illustrates how subcutaneous emphysema itself can be a potential cause of respiratory failure and tamponade physiology. In our case, a patient with traumatic subcutaneous emphysema developed respiratory failure and clinical deterioration after the introduction of positive pressure ventilation. In such rare scenarios, care should be taken to consider the absolute need for positive pressure ventilation without surgical decompression.

scholarly journals Veno-venous extracorporeal membrane oxygenation in the management of refractory bilateral bronchial dehiscence after lung transplant: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Makiko Tani
Keyword(s):  
Lung Transplant ◽  
Positive Pressure Ventilation ◽  
Positive Pressure ◽  
Case Presentation ◽  
Life Threatening ◽  
Pulmonary Arterial ◽  
Bilateral Lung ◽  
Bridge Therapy ◽  
Extracorporeal Oxygenation ◽  
Vv Ecmo

Abstract Background Bronchial dehiscence is a life-threatening complication after lung transplant. If it is not treated by placement of stent or reanastomosis, the chance of survival will depend on the availability of a new graft. However, retransplant is not a practical management option in Japan, where waiting time for lung transplant is extensive. We described a case of refractory bilateral bronchial dehiscence managed by veno-venous extracorporeal oxygenation membrane (VV ECMO) while allowing the dehiscence to heal. Case presentation A 25-year-old man with idiopathic pulmonary arterial hypertension underwent a bilateral lung transplant. The patient developed bilateral bronchial dehiscence. Open reanastomosis was not successful, and air leakage recurred under low positive pressure ventilation. VV ECMO was established to maintain oxygenation with spontaneous breathing until both dehiscence were closed by adhesions. Conclusion In a patient with refractory bilateral bronchial dehiscence, VV ECMO may provide bronchial rest and serve as a bridge therapy to recovery.

scholarly journals Prone Position as a Life-saving Measure for Acute Pulmonary Haemorrhage in a Young Adult with Cystic Fibrosis

2002 ◽  
Vol 30 (2) ◽  
pp. 223-225 ◽  
Author(s):  
R. Savage
Keyword(s):  
Cystic Fibrosis ◽  
Positive Pressure Ventilation ◽  
Rare Complication ◽  
Anaesthetic Techniques ◽  
Pulmonary Haemorrhage ◽  
Positive Pressure ◽  
Successful Management ◽  
Life Saving ◽  
Life Threatening ◽  
Saving Measure

Fatal pulmonary haemorrhage is a rare complication of cystic fibrosis. A case of unexpected life-threatening pulmonary haemorrhage is presented, and the successful management of this problem including immediate prone ventilation. Different anaesthetic techniques, avoiding endotracheal intubation and positive pressure ventilation, which may avoid similar complications, are described.

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