Propylene glycol toxicity associated with lorazepam infusion in a patient receiving continuous veno-venous hemofiltration with dialysis.

We report a case of toxicity from the drug solvent propylene glycol resulting from prolonged, large-dose lorazepam infusion. The case is unusual in that toxicity developed during continuous veno-venous hemofiltration with dialysis, a renal replacement therapy that should been have been effective at eliminating the chemical and its metabolites.

Succinylcholine-induced hyperkalemia in a patient with mucositis secondary to chemotherapy.

Objective: To report a case of fatal hyperkalemia owing to succinylcholine administration in a patient with mucositis secondary to chemotherapy.

Design: Case report.

Setting: Adult intensive care unit (ICU) at Dartmouth-Hitchcock Medical Center.

Cross-clamping the thoracic aorta. Effect on intracranial pressure.

A clinical case is reported indicating that intracranial pressure (ICP) rises with cross-clamping of the thoracic aorta (CCTA) in humans and does not fall if arterial blood pressure (BP) is lowered by nitroprusside. Hantler and Knight (Anesthesiology 1982;56:146-147) also reported a similar case. We investigated this phenomenon prospectively, measuring ICP, aortic arch BP, and right atrial pressure in 10 halothane-anesthetized New Zealand White rabbits ventilated to pH 7.