Accidental arterial puncture during right internal jugular vein cannulation in cardiac surgical patients.

Background: The primary aim of this study was to compare the incidence of accidental arterial puncture during right internal jugular vein (RIJV) cannulation with and without ultrasound guidance (USG). The secondary end points were to assess if USG improves the chances of successful first pass cannulation and if BMI has an impact on incidence of arterial puncture and the number of attempts that are to be made for successful cannulation.

Settings And Design: Prospective observational study performed at a single tertiary cardiac care center.

Cell salvage during coronary artery bypass surgery and allogenic blood exposure.

Aim: Our primary aim was to assess the impact of intraoperative cell saver usage on patient exposure to allogenic blood transfusion during elective coronary artery bypass. The secondary endpoint was the impact of cell savage on the units of blood and blood products transfused perioperatively.

Methods: A prospective observational cohort study with a historical cohort as a control group was performed in a single tertiary care center.

Wernicke's encephalopathy following hyperemesis gravidarum.

Wernicke's encephalopathy (WE) is a potentially reversible yet serious neurological manifestation caused by vitamin B1(thiamine) deficiency. It is commonly associated with heavy alcohol consumption. Other clinical associations are with hyperemesis gravidarum (HG), starvation, and prolonged intravenous feeding.

One lung ventilation in a patient with an upper and lower airway abnormality.

One-lung ventilation for a thoracotomy procedure was achieved with the help of a endobronchial blocker in a young girl with limited mouth opening, minimal neck extension, and a distorted tracheo-bronchial anatomy. As the patient would not cooperate for an awake nasotracheal intubation despite adequate preperation, an inhalational anesthetic was used to make the patient unconscious, taking care that spontaneous breathing was maintained. Nasotracheal intubation was done with the help of a fiberoptic bronchoscope.

Lupus anticoagulant and off-pump coronary bypass: dilemma of anticoagulation.

Confronted with a persistently elevated activated partial thromboplastin time due to circulating lupus anticoagulant in a patient undergoing emergency off-pump coronary artery bypass surgery, the dilemma of providing adequate anticoagulation for a short cardiac surgical procedure is highlighted.

Cardiopulmonary bypass without preoperative exchange transfusion in sicklers.

The effect of hypothermic cardiopulmonary bypass techniques on the sickling process was evaluated in patients with sickle cell hemoglobin. It was presumed that intraoperative hemolysis, as identified by hemoglobinuria, reflected increased sickling. Data of 43 patients with sickle cell traits and 2 with sickle cell disease, who were operated on under cardiopulmonary bypass and cold cardioplegic arrest in a tertiary center from the beginning of 1995 to the end of 2004, were retrospectively analyzed.

Postcardiac surgery complications: association of acute renal dysfunction and atrial fibrillation.

Unlabelled: Postoperative creatinine increase is associated with adverse outcome after cardiac surgery. Although postoperative stroke and renal dysfunction are associated after cardiac surgery, suggesting a common systemic insult, a similar assessment of atrial fibrillation and renal dysfunction has not been performed. Therefore, we tested the hypothesis that patients with new-onset atrial fibrillation complicating coronary bypass surgery have a greater postoperative creatinine increase.