Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Letter Randomized Controlled Trial
Association between intrapartum fetal head malrotation and motor block by neuraxial analgesia: a randomized trial.
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The purpose of this Continuing Professional Development Module is to review the issues pertinent to one-lung ventilation (OLV) and to propose a management strategy for ventilation before, during, and after lung isolation. ⋯ Optimal perioperative care of the thoracic patient includes a protective ventilation strategy from intubation to extubation and into the immediate postoperative period. Anesthetic goals include the prevention of perioperative hypoxemia and postoperative ALI.
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Takotsubo cardiomyopathy is characterized by the sudden onset of reversible left ventricular dysfunction. Associated refractory cardiogenic shock is a rare occurrence and may require extracorporeal membrane oxygenation (ECMO). We report a case of a patient who, following the inadvertent injection of 1 mg of epinephrine, presented with reverse Takotsubo cardiomyopathy and refractory cardiogenic shock that required the implementation of a percutaneous ECMO. ⋯ Takotsubo cardiomyopathy following an injection of epinephrine remains a rare but increasingly described occurrence. The severity of the symptoms appears to be patient dependent, but refractory cardiogenic shock may occur and require significant circulatory support. If this situation occurs in a hospital where this necessary equipment is lacking, a mobile ECMO unit appears to be a viable solution to optimize the patient's chances of survival.