Acute Respiratory Distress and Hyperchloremic Metabolic Acidosis as a Result of Massive Irrigation Fluid Extravasation After Arthroscopic Shoulder Surgery: A Case Report and Recommendations for Preventable Complications

Hemidiaphragmatic paralysis is initially recognised as postoperative respiratory distress. The subsequent sequential management of the patient following arthroscopic shoulder surgery under interscalene block is described. Ultrasound-guided technique is considered to be the safest for interscalene block. Reducing the volume of anaesthetic used reduces its spread to the phrenic nerve and thus reduces the incidence of hemidiaphragmatic paralysis. Furthermore, a reduction in anaesthetic volume has equivalent analgesic efficacy.

Download Full-text

Pleural effusion caused by extravasation of irrigation fluid during arthroscopic shoulder surgery - A case report -

Korean Journal of Anesthesiology ◽

10.4097/kjae.2009.56.2.217 ◽

2009 ◽

Vol 56 (2) ◽

pp. 217

Author(s):

Hyun Suk Yang ◽

In Young Huh ◽

Daewoo Kim ◽

Hee-won Son ◽

Eun-sun Park ◽

...

Keyword(s):

Case Report ◽

Pleural Effusion ◽

Shoulder Surgery ◽

Irrigation Fluid ◽

Arthroscopic Shoulder Surgery

Download Full-text

Hyperchloremic metabolic acidosis in diabetes mellitus: a case report and discussion of pathophysiologic mechanisms

Diabetes ◽

10.2337/diabetes.27.1.16 ◽

1978 ◽

Vol 27 (1) ◽

pp. 16-20 ◽

Cited By ~ 7

Author(s):

M. Hammeke ◽

R. Bear ◽

R. Lee ◽

M. Goldstein ◽

M. Halperin

Keyword(s):

Diabetes Mellitus ◽

Case Report ◽

Metabolic Acidosis ◽

Hyperchloremic Metabolic Acidosis ◽

Pathophysiologic Mechanisms

Download Full-text

Surgical reconstruction of the anterolateral acromion with a tricortical iliac crest bone graft after extensive acromioplasty

Obere Extremität ◽

10.1007/s11678-021-00624-1 ◽

2021 ◽

Author(s):

Anna-K. Tross ◽

Philip-C. Nolte ◽

Markus Loew ◽

Marc Schnetzke ◽

Sven Lichtenberg

Keyword(s):

Case Report ◽

Bone Graft ◽

Iliac Crest ◽

Deltoid Muscle ◽

Shoulder Surgery ◽

Surgical Reconstruction ◽

Iliac Crest Bone Graft ◽

Subacromial Decompression ◽

Arthroscopic Shoulder Surgery

AbstractSubacromial decompression is one of the most frequently performed procedures in the setting of arthroscopic shoulder surgery and typically includes acromioplasty. However, the indication for acromioplasty remains a subject of debate. Possible complications involve deltoid muscle insufficiency due to an excessive removal of the anterior acromion. This case report is intended to draw attention to this particular complication and its management.

Download Full-text

Hyperchloremic metabolic acidosis during bipolar transurethral resection of the prostate: a report of two cases

Journal of International Medical Research ◽

10.1177/03000605211024480 ◽

2021 ◽

Vol 49 (6) ◽

pp. 030006052110244

Author(s):

Ann Hee You ◽

Ji Yoo Lee ◽

Jeong-Hyun Choi ◽

Mi Kyeong Kim

Keyword(s):

Metabolic Acidosis ◽

Transurethral Resection ◽

Normal Saline ◽

Isotonic Saline ◽

Hemodynamic Instability ◽

Acid Base ◽

Electrolyte Disturbance ◽

Irrigation Fluid ◽

Laboratory Test Results ◽

Hyperchloremic Metabolic Acidosis

Compared with monopolar transurethral resection of the prostate (TURP), which requires electrolyte-free irrigation fluid, normal saline can be used as the irrigation solution in bipolar and laser TURP. The risk of TURP syndrome and severe electrolyte disturbance is minimized when normal saline is used as the irrigation fluid. However, the use of isotonic saline also causes acid-base imbalance and electrolyte disturbance. We experienced two patients who developed hyperchloremic metabolic acidosis during bipolar TURP. After proper intervention, hemodynamic instability resolved, and laboratory test results normalized. Anesthesiologists must pay attention to acid-base and electrolyte status when rapid absorption of excessive isotonic solution is suspected, even during bipolar and laser TURP, which use normal saline as the irrigation fluid.

Download Full-text