Chronotropic incompetence on dobutamine stress echocardiography in candidates for a liver transplant.

Objectives: We evaluated dobutamine stress echocardiography as an initial screening test for a cardiac evaluation before a liver transplant.

Materials And Methods: We retrospectively examined 111 liver transplant candidates who had undergone previous cardiac evaluation; 30 of whom had undergone a liver transplant.

Results: Eighty patients (72.

Anesthetic considerations in candidates for lung volume reduction surgery.

The administration of anesthesia to patients undergoing lung volume reduction surgery (LVRS) requires a complete understanding of the pathophysiology of severe chronic obstructive pulmonary disease, the planned surgical procedure, and the anticipated postoperative course for this group of patients. Risk factors and associated morbidity and mortality are discussed within the context of patients with obstructive pulmonary disease in the National Emphysema Treatment Trial having surgical procedures. Preoperative evaluation and the anesthetic techniques used for patients undergoing LVRS are reviewed, as are monitoring requirements.

A surprising twist: an unusual failure of a keyed filling device specific for a volatile inhaled anesthetic.

We describe two cases in which keyed filling devices for sevoflurane were inadvertently screwed onto isoflurane bottles. The mishaps were possible because the collars on sevoflurane and isoflurane bottles are mirror images of each other. The particular keyed filling device was designed with a flexible outer sleeve and could be screwed onto the wrong bottle while slightly gouging its soft plastic collar.