Efficacy of Quantra-Qplus System for Rapid Diagnosis and Treatment of Hypofibrinogenemia and Thrombocytopenia After Cardiopulmonary Bypass.

Objectives: To assess whether the Quantra-Qplus can provide the cutoff values for predicting transfusion thresholds after cardiopulmonary bypass.

Design: Prospective observational study.

Setting: Single-center university hospital.

A fragmented segment of a central venous catheter caused delayed ventricular fibrillation: a case report.

Background: Central venous port systems may be safely used for chemotherapy of patients with cancer, but several complications may occur associated with their use.

Case Presentation: An 83-year-old man with heat stroke was transferred to our emergency department, where he was treated and became able to eat on the same day. He had been fit and healthy, except for colorectomy and chemotherapy using a central venous access port placed in the right upper jugular vein 8 years ago.

Standard of anesthesia care: possible dissociation from recommendations made by clinical practice guidelines.

A medical malpractice lawsuit may be brought against health care providers, if there was a possibility of a negligence, or failure to meet the standard of care. Recently, clinical practice guidelines have increasingly been used as evidence of the standard of care. Nevertheless, it is not clear whether these guidelines can be used as evidence of the standard of care.

[Anesthetic Management of Laparoscopic Lower Gastrointestinal Tract Surgery].

This article reviews anesthetic management of lapa- roscopic lower gastrointestinal tract surgery. The recommended anesthetic method is general anesthesia, and tracheal intubation is an appropriate airway control method. It is important to understand hemodynamics and respiratory changes with pneumoperitoneum and Trendelenburg position during operation, especially in a patient with compromised cardiopulmonary functions.

[Stroke Volume Variation (SVV) as an Indicator of Intraoperative Transfusion Management during Laparoscopic Colectomy.].

Background: Intraoperative transfusion manage- ment is difficult during laparoscopic surgery, because peumoperitoneum affects hemodynamics. We studied whether stroke volume variation (SVV) is useful as an indicator of transfusion management Methods : We studied 44 patients undergoing lapa- roscopic colectomy. Patients were randomly allocated to two groups, and the volume of transfusion was decided with the SVV as an indicator in one group (SVV group, n=22) or with conventional indicators, such as blood pressure, heart rate, volume of urine in the other group (control group, n=22) Results : In the SVV group, total transfusion volume and total blood loss during operation were significantly decreased, and the length of hospital stay was signifi- cantly shorter, compared with the control group.

[Utility of McGRATH MAC for a Patient with a Large Epiglottic Cyst].

A 76-year-old man with an epiglottic cyst was scheduled for transoral rigid endoscopic epiglottic cystectomy under general anesthesia. The epiglottic cyst was found accidentally when he had an operation of radical cystectomy 2 weeks before. When he had the radical cystectomy, the ventilation through a mask was easy.

[Anesthetic Management of an Adrenoleukodystrophy Patient for Intrathecal Baclofen Therapy].

A 34-year-old man with adrenoleukodystrophy (ALD) was scheduled for pump system insertion of intrathecal baclofen therapy under general anesthesia. ALD, a rare genetic disorder, is associated with a total body increase in long chain fatty acids caused by defective degradation, and includes various nervous system abnormalities, muscular weakness, in addition to adrenal insufficiency. He had contracture of the both legs, and muscular weakness of the left hand, and Mallampati class III, but no respiratory disability.

[Anesthetic Management of a Pregnant Woman Undergoing Cesarean Section and Intestinal Tract Perforation Restoration].

We describe anesthetic management of a pregnant woman (weight 42 kg, height 147 cm) with ileus, requiring emergency cesarean section and ileus operation. Cesarean section was performed under spinal anesthesia and epidural anesthesia, and ileus operation was performed under total intravenous general anesthesia. During ileus operation, the blood pressure decreased to 60/30 mmHg and the heart rate increased to 140 beats x min, indicating the intestinal traction syndrome.

[Morphine-induced Anaphylaxis before Induction of Anesthesia].

We describe a case of anaphylaxia that occurred in a 67-year-old man. He was planned to have an operation on mitral valve prolapse (MVP) for mitral regurgitation (MR). Morphine 5 mg was injected intramusculaly 45 min before operation.

[Anesthetic Management of an Infant who Underwent Awake-intubation for Her Pharyngeal Injury Caused by a Toothbrush].

A 2-year-and-4-month-old female infant, 12 kg in weight and 90 cm in height fell off from a table, which was about 1 m height with a toothbrush in her mouth without her parents noticing. Urgent CT scan showed that it penetrated the left side of her oropharyngeal wall to the bifurcation of her right carotid artery. According to the initial assessment, carotid artery seemed intact and there seemed to be no sign of CNS involvement.

[Pentax AWS-s200: Its Advantages and Possible Problems].

The Pentax AWS-s200 (Hoya, Japan : s-200) is a new videolaryngoscope. Its weight is 190 g, and it is lighter than the original AWS (AWS-s100L: s-100). It has a USB port, and its screen is wider and clearer than the s-100.

[Usefulness of the McGRATH® Videolaryngoscope in 100 Children].

Background: The McGRATH® MAC videolaryngoscope (McG) is a new device for tracheal intubation. Its utility has been reported in both tracheal intubation in children and difficult tracheal intubation for adults. Initially, the blade introduced was for adult use only, but the one for children was also in the market.

[Use of a New Video-laryngoscope (McGRATH® X-blade™) in Patients with Difficult Airways].

We describe the use of a new video-laryngoscope (McGRATH® X-blade™, X-blade) in patients with difficult airways. We report four cases of difficult and failed tracheal intubation using a conventional Machintosh laryngoscope and McGRATH® MAC in which tracheal intubation was accomplished swiftly and easily using a newly designed videolaryngoscope, the X-blade. The whole glottis was easily visible (Cormack-Lehane grade 1) with the X-blade.

[Usefulness of ACUSON Freestyle (Siemens), Wireless Ultrasound System].

The ACUSON Freestyle, the world's first wireless ultrasound system, was released in April 2014. We assessed its usefulness, using it for central venous cannulation, spinal anesthesia, brachial plexus or obturator nerve block, and for the surgery of metastatic liver cancer as well as the spine. Generally, we could use it smoothly in all situations.

[Intubation Using a Double-lumen Tube with a Combination of Fiberoptic Bronchoscope and the Glidescope in a Patient with Difficult Airway].

A 54-year-old man with lung cancer was scheduled for thoracoscopic upper lobe resection under general anesthesia. About half a year previously, he had undergone surgery for oropharyngeal cancer and tongue cancer. As a result of the surgery, elasticity of the neck skin bending of the neck were restricted (Mallampati classification IV).

[Tracheal Intubation via the i-gel and the Aintree Intubation Catheter in a Patient with Unexpected Difficult Intubation].

A 64-year-old man was scheduled for radical sinus operation. Preoperatively, we did not expect difficult airway. We induced general anesthesia, and ventilation via facemask was adequate, but tracheal intubation using a Macintosh laryngoscope was difficult (Cormack-Lehane classification III).

[Comparison of Seven Intubation Devices in Difficult Airway Model].

Background: The efficacy in tracheal intubation may differ between different video-optical devices, in particular in patients with difficult airways. The purpose of this study was to evaluate the efficacy of video-laryngoscopes and fiberoptic bronchoscope (FOB) in tracheal intubation on a mannequin with several difficult airways, including limited mouth opening, cervical spine rigidity and tongue edema.

Methods: Residents performed tracheal intubation on a mannequin using Macintosh laryngoscope (Mac), rigid indirect-optical intubation devices and FOB.

[Anesthetic Management of a Patient with Corrected Transposition of Great Arteries for Cesarean Section].

A 30-year-old woman with corrected transposition of great arteries (c-TGA) was scheduled for elective cesarean section at 37 weeks of gestation. At previous cesarean section, she received general anesthesia for dyspnea and lower cardiac function by severe mitral regurgitation, with a pulmonary catheter inserted. In the current pregnancy, she had tricuspid regurgitation, but she had no signs of heart failure.

A mathematical model to predict protein wash out kinetics during whole-lung lavage in autoimmune pulmonary alveolar proteinosis.

Whole-lung lavage (WLL) remains the standard therapy for pulmonary alveolar proteinosis (PAP), a process in which accumulated surfactants are washed out of the lung with 0.5-2.0 l of saline aliquots for 10-30 wash cycles.

[Airway obstruction during attempts at fiberoptic intubation in an awake patient].

A 67-year-old woman with rheumatoid arthritis was scheduled for lumbar anterior fusion (L5-S1). The patient had undergone several major operations on the cervical to the lumbar spine. Cervical spine movement was severely restricted, the mouth opening was limited (inter-incisor distance 3 cm), and the jaw was small (thyro-mental distance 2 cm).

[Video-laryngoscope (McGRATH MAC): a clinical assessment of its performance in consecutive 100 patients].

Background: The McGRATH MAC Video laryngoscope (Covidien Japan) is a relatively new device for tracheal intubation, which provides an excellent glottis view. We here report the clinical experience of the McGRATH in 100 patients who received general anesthesia.

Methods: Tracheal intubation with the McGRATH was performed in 100 patients requiring oro/naso tracheal intubation.

[Fiberoptic tracheal intubation through a laryngeal mask airway in a pediatric patient with treacher collins syndrome].

A 6-month-old girl with Treacher Collins syndrome was scheduled for tracheotomy because of severe airway obstruction. During slow induction of anesthesia with inhalation of sevoflurane, assisted mask ventilation was successfully performed using oropharyngeal airway. Either direct laryngoscope or GlideScope Video Laryngoscope could not reveal any part of the epiglottis (Cormack and Lehane grade 4).

[Use of a new video-laryngoscope (McGRATH MAC) in patients with a difficult airway].

We describe the clinical use of a new video-laryngoscope (McGRATH MAC, McG) in patients with a difficult airway and morbid obesity. In a patient, case no. 2, with a difficult airway, showing a Cormack-Lehane grade III view with Macintosh direct laryngoscope, the glottis opening (Cormack-Lehane grade I) was visualized with McG.