A&A practice
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We report a rare case of iatrogenic arterial cannula transection during a dressing change and migration of the distal fragment within the radial artery. The retained intraarterial fragment was successfully located using ultrasound, enabling swift surgical removal. We discuss the risk factors associated with arterial cannula transection and the efficacy of imaging modalities in locating the intraarterial fragment.
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High-flow nasal oxygen (HFNO) is a potentially life-saving adjunct in the emergency management of the obstructed airway. HFNO has multiple beneficial applications in critical care and respiratory support, but its use in emergency-obstructed airway management has not been defined. ⋯ Oxygenation, carbon dioxide levels, and airway patency were maintained, which facilitated endotracheal intubation while the patient was spontaneously breathing during general anesthesia. The application of HFNO can be extended to emergency airway obstruction.
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Permanent pacemakers are used for a variety of conditions and are commonly encountered in the perioperative period. This report describes the anesthetic management of a patient with a permanent pacemaker with a rate drop response (RDR) who presented for a laparoscopic left adrenalectomy. The RDR setting is a novel pacemaker mode often used in patients with a history of vasovagal syncope. ⋯ This case report describes the features of the RDR setting with the goal of educating clinicians who may encounter patients with this type of pacemaker. The patient described in this case report had large swings in blood pressure intraoperatively due to the natural function of his pacemaker. This report highlights the importance of understanding pacemaker modes in patients about to undergo surgery, especially because pacemaker functions are becoming increasingly sophisticated and more personalized to meet patients' specific needs.