Successful treatment of acute respiratory distress syndrome after hysterectomy for life-threatening atonic bleeding by inhaled nitric oxide.

We report a case of a 33-year-old female who developed severe acute respiratory distress syndrome (ARDS) after emergency hysterectomy for life-threatening atonic bleeding. A marked decline in pulmonary oxygenation was observed during the surgery, which led to a diagnosis of ARDS. Following admission to the intensive care unit, hypoxia became critical, with a PaO(2)/F(I)O(2) value of 52 even after recruitment maneuvers.

Middle-ear pressure variations during total intravenous anesthesia with propofol, fentanyl, and ketamine.

Purpose: As the middle-ear cavity is one of the noncompliant gas-filled cavities, an increase in middle-ear pressure (MEP) instead of volume expansion is observed with inhalation of nitrous oxide (NO). Changes in MEP cause many complications, such as ear pain, temporary hearing impairment, and postoperative emesis. Therefore, we investigated changes in MEP during total intravenous anesthesia (TIVA) with propofol, fentanyl, and ketamine (PFK) and inhalation of NO.