A&A practice
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Case Reports
Awake Intubation via an Ambu AuraGain in a Patient With Extreme Obesity: A Case Report.
Severe obesity is associated with increased morbidity and mortality. Airway management is challenging due to difficulties in positioning and airway management and altered pulmonary physiology. ⋯ The procedure was well tolerated and easily performed in the full sitting position for optimal airway and ventilation and cardiovascular stability during intubation. To our knowledge, this is the first published report of awake flexible bronchoscopic intubation via an AuraGain, and we discuss our rationale for using this technique.
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Generally the oxygram and the capnogram are mirror images of each other. We report a situation where a leak in the sample line produced a typical tails-up capnogram that was not accompanied by a mirror image oxygram. Air entrainment through the breach led to dilution of the gases on their way to the analyzer. The result was an oxygram resembling a series of mountain peaks.
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Case Reports
Titration of Bivalirudin Infusion in the Pediatric Cardiac Catheterization Laboratory: A Case Report.
Bivalirudin is a direct thrombin inhibitor that is used as a procedural anticoagulant during percutaneous coronary interventions and cardiac surgery for patients with heparin-resistant thrombosis or heparin-induced thrombocytopenia. There is a robust literature describing its safety and efficacy in adults; however, its use in the pediatric population is relatively rare, with dosing extrapolated from adult data. In this case report, we describe a 4-year-old with complex congenital heart disease and history of heparin-induced thrombocytopenia who required bivalirudin dose uptitration during cardiac catheterization.