RESUMO
Castleman's disease (CD) is a rare lymphoproliferative disorder of undetermined etiology. Unicentric Castleman's disease is confined to a single lymph node; it is usually asymptomatic though sometimes has local manifestations related to mass effects. In contrast, multicentric Castleman's disease (MCD) typically presents with lymphoid hyperplasia at multiple sites; it is associated with systemic symptoms and abnormal laboratory findings, with a less favorable prognosis. In case of anesthesia in CD, an exhaustive preanesthetic evaluation is essential to identify associated clinical manifestations which may influence the management of the anesthesia. Perioperative careful monitoring and proper anesthetic management are both important. We report a case of general anesthesia with anesthetic management in a patient with MCD that has not been documented in the literature.
Assuntos
Humanos , Anestesia , Anestesia Geral , Hiperplasia do Linfonodo Gigante , Hiperplasia , Linfonodos , Transtornos Linfoproliferativos , PrognósticoRESUMO
Neurogenic pulmonary edema (NPE) in brain dead organ donors occurring after an acute central nervous system insult threatens organ preservation of potential organ donors and the outcome of organ donation. Hence the active and immediate management of NPE is critical. In this case, a 50-year-old male was admitted to the intensive care unit (ICU) for organ donation. He was hypoxic due to NPE induced by spontaneous intracerebral hemorrhage and intraventricular hemorrhage. Protective ventilatory management, intermittent recruitment maneuvers, and supportive treatment were maintained in the ICU and the operating room (OR). Despite this management, the hypoxemia worsened after the OR admission. So inhaled nitric oxide (NO) therapy was performed during the operation, and the hypoxic phenomena showed remarkable improvement. The organ retrieval was successfully completed. Therefore, NO inhalation can be helpful in the improvement of hypoxemia caused by NPE in brain dead organ donors during anesthesia for the organ donation.
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Anestesia , Hipóxia , Morte Encefálica , Sistema Nervoso Central , Hemorragia Cerebral , Hemorragia , Inalação , Unidades de Terapia Intensiva , Óxido Nítrico , Salas Cirúrgicas , Preservação de Órgãos , Edema Pulmonar , Coleta de Tecidos e Órgãos , Obtenção de Tecidos e Órgãos , Doadores de TecidosRESUMO
Transient left bundle branch block (LBBB) is uncommon during anesthesia. It is mainly related to the changes in blood pressure or heart rate. Its occurrence can be confused with acute myocardial ischemia or ventricular tachycardia, therefore differential diagnosis is important. We report a case of transient LBBB which developed with hypoxia during monitored anesthesia care. LBBB is reversed to sinus rhythm after recovery from hypoxia.