Department of Anesthesiology and Perioperative Medicine
http://hdl.handle.net/10675.2/923
2024-03-28T15:06:54ZAbsolute cerebral oximeters for cardiovascular surgical cases
http://hdl.handle.net/10675.2/294379
Absolute cerebral oximeters for cardiovascular surgical cases
Arthur, Mary E.
In the US, about 465,000 cardiopulmonary bypass grafting (CABG) procedures are performed every year. Decreases in oxygen levels occur in about 17-23% of CABG procedures which cause brain injury even in uncomplicated surgeries, and may lead to stroke, cognitive dysfunction, longer ventilation times; longer ICU and hospital stays, and higher health care costs. Because of the brain’s high metabolic rate with limited oxygen reserves, only about 10 seconds at normal body temperature makes the brain is susceptible to oxygen deprivation. A study on patients who underwent CABG surgery found that incidence of cognitive decline was 53% at discharge and 42% at 5 years (Newman, 2001). Furthermore, elderly patients are more likely to develop cerebral desaturation because of age-related reductions in physiologic reserve (Casati, 2005), and the number of surgeries involving older patients is on the rise.
2013-02-01T00:00:00ZAnterior Mediastinal Mass in a Patient Requiring Lung Isolation
http://hdl.handle.net/10675.2/962
Anterior Mediastinal Mass in a Patient Requiring Lung Isolation
Janardhanam, Ram; Patel, Vijay; Arthur, Mary E.
A patient with an anterior mediastinal mass poses numerous challenges to an anesthesiologist, the major concerns being pulmonary or cardiac collapse on induction of anesthesia. Preoperative evaluation of the chest x-ray as well as the CT scan is valuable in assessing potential problems regarding management of this type of airway. An awake fiberoptic intubation is the preferred method of securing the airway.
2010-10-01T00:00:00ZUse of the Video RIFL (Rigid Flexible Laryngoscope) as an Adjunct to Direct Laryngoscopy
http://hdl.handle.net/10675.2/961
Use of the Video RIFL (Rigid Flexible Laryngoscope) as an Adjunct to Direct Laryngoscopy
Setty, Harsha; Gallen, Thomas; Dubin, Stevin
The ASA difficult airway algorithm incorporates different modalities in its progression. It is not uncommon for the user to fail at direct laryngoscopy, thus requiring an alternate method for securing an airway. Frequently, the alternate modalities include supraglottic airways, rigid videolaryngoscopes, or flexible fiberoptic bronchoscopes. We retrospectively reviewed charts from February 2009 to February 2010 on patients intubated in the operating room using the Video RIFL.
2010-09-01T00:00:00ZGranulomatous Conduit for Intrathecal Infusion of Morphine and Bupivacaine
http://hdl.handle.net/10675.2/960
Granulomatous Conduit for Intrathecal Infusion of Morphine and Bupivacaine
Webb, David M; Schneider, John R; Lober, Robert M.; Vender, John R.
Intrathecal Drug Delivery Systems (IT-DDS) have gained widespread acceptance as a therapeutic alternative to high dose parenteral opioids for unremitting chronic pain. Granuloma formation has been reported as a side effect in association with the greater use of IT-DDS. Etiological factors include infection, reaction to catheter material, and trauma at the site of implantation. The most widely accepted etiology is the use of intrathecal morphine, with granuloma formation dependent on morphine dosage. We present the case of a woman with unremitting GI pain and IT-DDS placement who developed a granuloma at the hub of the catheter which formed a sealed conduit that re-established drug flow between the pump and catheter.
2010-11-01T00:00:00Z