Objective: The objective of this case report is to describe the management of anesthesia of a patient with an LVAD that underwent an emergency open appendectomy. Literature regarding emergency anesthesia management of such patients is still limited. A search in the PubMed engine with the keywords "LVAD appendectomy anesthesia management" revealed no results.
Case Report: The case regards a 54 years old male patient that received an LVAD implant 2 months before the current incident. Close monitoring was applied including invasive arterial pressure measurement. Etomidate was selected for induction thanks to its' insignificant hemodynamic effects. Careful titrated drug and liquids administration was applied to avoid hemodynamic destabilization. Anticoagulation treatment cannot be stopped in these patients, and there was no time for anticoagulation treatment changes. Two units of fresh frozen plasma were issued as preventive bleeding measures.
Results: No hemodynamic destabilization (targeted MAP: 65-90 mmHg) and bleeding were registered. The patient was extubated without any complications.
Conclusions: Anesthesia management of similar cases should be focused around bleeding and hemodynamic destabilization and is harder in emergency surgery due to narrow time limits. Drug and liquids titration and use of drugs with minimum hemodynamic effects are advised, as well as close cardiovascular monitoring.
Download full-text PDF |
Source |
|---|
Publication Analysis
Top Keywords
Similar Publications
The Danish Drowning Cohort: Utstein-style data from fatal and non-fatal drowning incidents in Denmark.
BMC Med Res Methodol
January 2025
Prehospital Center Region Zealand, Ringstedgade 61, 14th Floor, Naestved, 4700, Denmark.
Background: Effective interventions to reduce drowning incidents require accurate and reliable data for scientific analysis. However, the lack of high-quality evidence and the variability in drowning terminology, definitions, and outcomes present significant challenges in assessing studies to inform drowning guidelines. Many drowning reports use inappropriate classifications for drowning incidents, which significantly contributes to the underreporting of drowning.
View Article and Find Full Text PDFPreoperative halo-pelvic traction leading to near-complete airway obstruction in a child with severe thoracic lordosis and scoliosis: a case report.
BMC Anesthesiol
January 2025
Department of Anesthesiology, Peking Union Medical College Hospital, Beijing, China.
Background: Halo-pelvic traction is a relatively safe treatment for preoperative spinal deformity correction in patients with severe scoliosis. Common device-related complications include local infection, back discomfort, and nerve compression symptoms. However, there are potential risks of mechanical compression of bronchial structures, especially in patients with severe thoracic lordosis and scoliosis, which can lead to life-threatening airway obstruction.
View Article and Find Full Text PDFComparison of postoperative oxygenation in children receiving sugammadex versus neostigmine for reversal of neuromuscular blockade: a retrospective cohort study.
Can J Anaesth
January 2025
Outcomes Research Consortium, Houston, TX, USA.
Purpose: Residual neuromuscular blockade can impair postoperative respiratory mechanics, promoting hypoxemia and pulmonary complications. Sugammadex, with its unique mechanism of action, may offer a more effective reversal of neuromuscular blockade and respiratory function than neostigmine. We sought to test the primary hypothesis that children undergoing noncardiac surgery exhibit better initial recovery oxygenation when administered sugammadex than those administered neostigmine.
View Article and Find Full Text PDFCurrent airway management practice among Swiss anesthesiologists : Results of a national survey.
Anaesthesiologie
January 2025
Department of Anaesthesia, Spital Grabs, 9472, Grabs, Switzerland.
Background: While limited data on the impact of implementing guidelines in airway management on outcomes exist, there is a consensus that the implementation and the adherence to guidelines enhance patient safety. Recently, the Swiss Society for Anesthesiology and Perioperative Medicine (SSAPM) endorsed the guidelines of The Fondation Latine des Voies Aériennes (FLAVA) as the official guidelines for airway management in Switzerland. This study aimed to determine current practice of airway management in Switzerland.
View Article and Find Full Text PDF[User behavior during functional testing of the ventilator: analysis of the use of the QUICKcheck and detection of misconnected ventilation tubes].
Anaesthesiologie
January 2025
Medizinische Fakultät Heidelberg, Klinik für Anästhesiologie, Universität Heidelberg, Im Neuenheimer Feld 420, Heidelberg, Deutschland.
Background And Research Question: While patient safety during general anesthesia has improved in recent years, incidents still occur in anesthesia, particularly in the area of airway management and ventilation. In addition to a mandatory daily system test before using a ventilator, a QUICK check is recommended by the German Society of Anesthesiology and Intensive Care Medicine (DGAI) before connecting a patient; however, misconnections of breathing tubes are still possible and not necessarily detected by the device self-test. The aim of the present study was to analyze user behavior at modern anesthesia workstations regarding the verification and functionality of the QUICK check.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!