Nasogastric tube placement errors and complications in pediatric intensive care unit: a case report

Nasal ala pressure sores are among complications of nasogastric tube in Pediatric Intensive Care Unit [PICU]. The severity of the injury is usually minor and easily ignored. However, the complication could be easily avoided. This is a case of nasal ala sore after the placement of nasal enteral tube in a pediatric intensive care unit in our center. A 5-month-old female with pulmonary hypertension secondary to bronchiectasis with nasal ala pressure sore were reported. She was hospitalized in pediatric intensive care unit at Tabriz Children Hospital in 2010.After 53 days of PICU hospitaliza-tion she had nasal ala sore. Conclusion: We know that nasal ala pressure sores could easily be avoided when preventive procedures were performed during nasogastric tube insertion

Comparison of cardiac stress index with rate pressure product in trans - abdominal prostatectomy

The current study is to evaluate cardiovascular effects of anesthetic medications and volatile anesthetics on cardiac stress using cardiac stress index [CSI] and rate pressure product [RPP] and to determine which of them in useful in evaluating cardiac stress after comparing results obtained from each method. Forty patients, 60-80 years old, who were all performed Trans abdominal prostatectomy, were studied. Patients were divided into tm groups; half of patients were placed in group A and the other half in group B. The study was carried out as a blinded study. CCSI was measured and evaluated in group A and RPP changes were studied in group B. The mean CSI were 60.25 +/- 5.57, 63.05 +/- .54, 55.75 +/- 4.78 and 67.65 +/- 4.88 before anesthesia induction, after induction, before surgical incision and in recovery respectively. There was no meaningful difference among these four stages measurements. RPP mean in four above mentioned stages was 10.15 +/- 0.44, 9.9 +/- 0.69, 6.8 +/- 0.36 and 9.2 +/- 0.61 respectively. There was a significant difference between RPP in stages before anesthesia induction and before surgical incision [P< 0.0001]. Considering the obtained results from this study, it can be seen that even in non-cardiac surgery, the stress level is high in patients in preoperative period. This condition was not clear in RPP index case and was not in accordance with CSI, which means CSI has been able to illustrate existing stress level better and efficiently

Cardiac arrest in a case of mucopolysaceharidosis after tracheostomy

Airway management during induction of anesthesia is difficult in some metabolic disorders like mucopolysaccharidosis [MPS]. In this article we report an 11 years old child with Hurler-Scheie syndrome how was admitted to operating room for thracheostomy under general anesthesia. Mask ventilation was difficult and endotracheal intubation was impossible and anesthesiologist ventilated the patient's lung by inserting laryngeal mask airway. The purpose of this article is to increase awareness among anesthetists and surgeons about the anatomical and pathophysiological changes in these syndrome which may lead to severe airway problems and complications in perioperative period

Tracheo-esophageal fistula after disk battery ingestion

Foreign body ingestion is a common complaint in the pediatric emergency departments. Esophageal foreign body is a potentially serious cause of morbidity and mortality in children. Here we report an interesting case of disk battery ingestion resulting tracheo-esophageal fistula [TEF]. The surgery for repair of TEF was done one month after ingestion. A brief review of the diagnosis and management of esophageal foreign bodies is presented with particular focus on ingested disk batteries