A&A practice
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We report kinking of the pilot line of an endotracheal tube (ETT). The anesthesiologist found it difficult to deflate the ETT cuff after performing test inflation with air before intubation. ⋯ This examination revealed stenosis of the pilot line at the entry into the ETT, making it too narrow for air to flow freely during cuff deflation. The present case emphasizes that preanesthetic checking of the ETT cuff is very important.
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In this case, the novel use of high-flow nasal oxygen successfully treated severe hypoxia by delivering oxygen through a very narrow space between the bronchoscope and the tracheal wall. Removal of a foreign body from a child's lung can be associated with hypoxia and cardiorespiratory arrest. ⋯ This simultaneous use can compromise gas exchange, leading to hypoxia. In this case, high-flow nasal oxygen supplemented bronchoscope oxygenation to treat a severely hypoxic child and facilitate subsequent removal of a peanut without further incident.
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Case Reports
Carotid Endarterectomy in a Patient With Type 2 Myocardial Infarction During Preparation for Surgery: A Case Report.
We present a patient who was admitted for carotid endarterectomy due to tight carotid stenosis and recent amaurosis fugax. His medical history included significant coronary artery disease with stable angina pectoris, hypertension with wide pulse pressure, chronic renal failure, and anemia. ⋯ The patient posed a serious clinical dilemma whether to continue with surgery despite the type 2 myocardial infarction or postpone the surgery. We discuss the diagnostic tests and the decision-making processes that guided us in the preoperative period.
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Case Reports
Spinal Cord Stimulation in Patients With Chronic Pain and Restless Legs Syndrome: A Case Report.
Restless legs syndrome can be a debilitating condition that affects a patient's ability to function and their quality of life. Neuromodulation may represent a potential option for nonpharmacological management of restless legs syndrome. ⋯ After neuromodulation, all 3 patients had improvement in their restless legs syndrome symptoms and were taking less pain medication, and 2 out of 3 had significantly improved functionality at short-term follow-up. This case series suggests that spinal cord stimulation may be a viable nonpharmacological treatment option for medically refractory restless legs syndrome.