ABSTRACT
A 1.1 Kg, four-hour-old, 29-weeks-gestation male patient presented with right upper extremity ischemia secondary to neonatal constriction band syndrome. Emergency constriction band release was deemed necessary to facilitate limb salvage. The anesthetic management of this patient required close communication with the surgical team and meticulous attention to the risks of post-reperfusion syndrome and blood loss in this fragile neonate. Limb salvage was ultimately successful, and the patient demonstrated full neurologic recovery at his two-year follow-up visit.
ABSTRACT
In pediatric patients experiencing blunt chest trauma, tracheobronchial avulsion injuries are rare but frequently fatal. We report the case of a 13-year-old boy who presented to our trauma center following a semitruck versus pedestrian collision. During his operative course, he developed refractory hypoxemia requiring emergency venovenous (VV) extracorporeal membrane oxygenation (ECMO) support. After stabilization, a complete right mainstem bronchus avulsion was identified and treated.
Subject(s)
Extracorporeal Membrane Oxygenation , Multiple Trauma , Thoracic Injuries , Wounds, Nonpenetrating , Male , Humans , Child , Adolescent , Thoracic Injuries/surgery , Wounds, Nonpenetrating/complications , Wounds, Nonpenetrating/surgery , Bronchi/surgery , Multiple Trauma/surgeryABSTRACT
Venous air embolism is a rare but potentially catastrophic complication of endoscopic retrograde cholangiopancreatography. We report 2 cases of venous air embolism and subsequent cardiac arrests. During resuscitation efforts, a transesophageal echocardiogram was placed, which demonstrated significant air in the right heart. Although gastroenterologists seem to be more aware of this complication, it is underreported in the anesthesiology literature. As anesthesiologists continue to expand coverage to endoscopy suites, anesthesia providers must be aware of predisposing factors and maintain a high index of suspicion to recognize and treat in a timely manner to prevent serious adverse outcomes.
