Pulmonary Alveolar Proteinosis in Children: Diagnosis and Treatment Outcomes.

Background: Pulmonary Alveolar Proteinosis (PAP) is an uncommon pulmonary disease characterized by the accumulation of surfactant composed of proteins and lipids due to disruption of surfactant clearance by alveolar macrophages. The current standard treatment is lung lavage. There are no specific criteria for lavage, but in case of observing these signs it is recommended to perform lavage for the patient: progressive respiratory failure, no labored breathing at rest, and drop in oxygen level during activity (>5%).

Unilateral Epidural Blockade for Lower Limb Fracture Surgery: Parasagittal Epidural Versus Midline Epidural Anesthesia.

Objective: To compare the efficacy of parasagittal interlaminar (PIL) and midline interlaminar (MIL) approaches for epidural block in patients with lower limb orthopedic surgery.

Methods: This double-blind randomized clinical trial was performed on 40 patients undergoing tibial shaft fracture surgery. In PIL group, an 18-gauge, 3.

High-Frequency Jet Ventilation in Nonintubated Patients.

Objectives: High-frequency jet ventilation (HFJV) is a convenient method for providing ventilation during fiberoptic bronchoscopy. We describe an incipient approach of high-frequency jet ventilation via the working channel of a flexible bronchoscope for nonintubated patients who suffer from hypoxemia during bronchoscopy. The aim of this study was to test the efficacy of this incipient approach and determine the possible complications related to it.

An eleven-year retrospective cross-sectional study on pulmonary alveolar proteinosis.

Introduction: Pulmonary alveolar proteinosis (PAP) is a rare disease in the field of pulmonary medicine. The efficacy of whole-lung lavage (WLL) as the treatment of PAP had never been evaluated in the Iranian population. Therefore, there is a real need to investigate the characteristics of PAP and also to evaluate the efficacy of WLL in this rare disease.

Paracetamol Instead of Ketorolac in Post-Video-Assisted Thoracic Surgery Pain Management: A Randomized Trial.

Background: Video-assisted thoracic surgery (VATS) is a minimally invasive procedure that is growing more common around the world. Despite causing less pain compared open thoracic surgery, postoperative pain management is still important.

Objectives: The aim of the present study was to compare the analgesic effects of paracetamol and ketorolac in VATS patients.

Thoracoscopic lobectomy in a patient with permanent tracheostomy.

One Lung Ventilation (OLV) is the preferred method of anesthesia in the vast majority of thoracic operations, especially thoracoscopic procedures. Although double lumen endotracheal tubes are usually used to conduct OLV during thoracic operations, in patients with permanent tracheostomy, because of short trachea, keeping these tubes safe in place is usually difficult. Thus, OLV in patients with permanent tracheostomy may be challenging or even impossible.

Effects of propofol versus isoflurane on liver function after open thoracotomy.

Background: Anesthetic agents and type of surgery may contribute to postoperative hepatic injury. Inhalational anesthetics have been associated with hepatic dysfunction after surgery, however, propofol is expected to have a lower potential for postoperative liver injury. This prospective double-blind randomized clinical study was planned to determine whether postoperative liver function differs after anesthesia with isoflurane and total intravenous anesthesia with propofol in patients undergoing a posterolateral thoracotomy.

Application of intra-aortic balloon pump in resection and anastomosis of trachea.

The intra-aortic balloon pump (IABP) is a mechanical device used to assist cardiac circulatory function in patients suffering from cardiogenic shock, congestive heart failure, refractory angina and complications of myocardial infarction. While using IABP in cardiac surgery is well established, there are few studies on the utility of IABP support in high-risk cardiac patients undergoing non-cardiac surgery. Major non-cardiac surgeries are associated with high rates of cardiac complications in patients with advanced coronary disease.

Heart-lung transplantation in Iran: a case report.

We report our initial experience with a heart-lung transplant operation performed on a 12- year- old girl with Eisenmenger syndrome at Masih Daneshvari Teaching Hospital in Tehran, in 2009. We also outline the operative indications, anesthetic management, and postoperative complications of heart-lung transplantation. We hope that this issue on transplantation may provide an encouraging prospect for patients with end-stage cardiopulmonary disorders in Iran.

Acute respiratory failure as a rare complication of celiac plexus block in a patient with adenocarcinoma of the ampulla of vater.

Celiac and splanchnic plexus blocks are considered as terminal approaches for pain control in end stage pancreatic cancer. It may be done temporarily (using local anesthetics) or as a permanent act (using alcohol and/or phenol). Like every other interventional procedure, celiac plexus block has its own potential complications and hazards among them pneumothorax and ARDS are very rare.

The efficacy of a single dose of pethidine, fentanyl and morphine in treating postanesthesia shivering.

Postanesthesia shivering is an undesirable event that may induce a variety of adverse consequences including patient discomfort, increased oxygen consumption and wound pain. Thus, its pharmacological treatment should be regarded. The purpose of this study was to compare the efficacy of morphine, fentanyl and pethidine for the treatment of postanesthesia shivering.

Postlung transplant rehospitalization: a study of causes, health care burden, and outcomes.

Objectives: Rehospitalization is a significant burden for transplant systems, which use data on hospitalization to monitor practice outcomes. In this study, all rehospitalizations after successful lung transplant performed in our medical center during an 8-year period were assessed for cause, health care resource use, cost, and outcome.

Materials And Methods: We performed a retrospective chart review of all rehospitalizations of lung transplant recipients in Masih Daneshvari Hospital in Darabad, Tehran, between 2000 and 2008.

Interpleural morphine vs bupivacaine for postthoracotomy pain relief.

This prospective randomized double-blind trial was designed to compare the analgesic effects of interpleural bupivacaine and interpleural morphine for postthoracotomy pain management. Thirty-six American Society of Anesthesiologists class I and II patients undergoing an elective posterolateral thoracotomy were randomly divided into 2 groups of 18 each. Before chest closure, an interpleural catheter was inserted under direct vision.

The anesthetic management of an intrabronchial escape of a hydatid's ruptured laminated membrane during rigid bronchoscopy.

We describe the anesthetic management of a case in whom a previously undiagnosed pulmonary hydatid cyst manifested as a large amount of intrabronchial fragmented pieces of laminated membrane suddenly and unexpectedly during diagnostic rigid bronchoscopy.