Anesthetic management of an 8-month-old infant with osteogenesis imperfecta undergoing liver transplantation: a case report / 대한마취과학회지

Anesthetic management of pediatric liver transplantation in a patient with osteogenesis imperfecta (OI) requires tough decisions and comprehensive considerations of the cascade of effects that may arise and the required monitoring. Total intravenous anesthesia (TIVA) with propofol and remifentanil was chosen as the main anesthetic strategy. Malignant hyperthermia (MH), skeletal fragility, anhepatic phase during liver transplantation, uncertainties of TIVA in children, and propofol infusion syndrome were considered and monitored. There were no adverse events during the operation. Despite meticulous precautions with regard to the risk of MH, there was an episode of high fever (40degrees C) in the ICU a few hours after the operation, which was initially feared as MH. Fortunately, MH was ruled out as the fever subsided soon after hydration and antipyretics were given. Although the delivery of supportive care and the administration of dantrolene are the core principles in the management of MH, perioperative fever does not always mean a MH in patients at risk for MH, and other common causes of fever should also be considered.

Anesthetic management for transfusion-free Rastelli's procedure in a pediatric Jehovah's Witness patient / 대한마취과학회지

No abstract available.

The neuroprotective effect of colloids in forebrain ischemia model

BACKGROUND: The aim of this study was to investigate the neuroprotective effects of colloids (albumin and pentastarch) after forebrain global ischemia in rats. METHODS: Thirty male Sprague-Dawley rats were randomly assigned to three groups; control, albumin and pentastarch group (each n = 10). Forebrain ischemia was induced by bilateral common carotid artery occlusion plus hemorrhagic hypotension. The control group received no treatment. The albumin group received 5 ml/kg of 20% albumin after ischemia. The pentastarch group received same volume of albumin after ischemia. Histologic outcomes were measured at 7 days after ischemia in CA1 pyramidal cells of the rat hippocampus. RESULTS: The mean percentage of viable cells in the hippocampal CA1 area was significantly higher in the albumin (47%) compared with the control group (33%) or pentastarch group (33%) (P = 0.001). The percentage of apoptotic cells was significantly lower in the albumin (30%) group than that in the pentastarch (44%) or control group (49%) (P = 0.006). CONCLUSIONS: This study shows that albumin can improve histologic outcomes after forebrain global ischemia compared with pentastarch.