Journal of clinical anesthesia
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Case Reports
Diagnosis of a left-sided superior vena cava during placement of a pulmonary artery catheter.
We report a case of a left sided superior vena cava (SVC) that was diagnosed during placement of a pulmonary artery (PA) catheter. After entering the left internal jugular, the PA catheter passed into the left side of the heart, through the aortic valve, and into the aorta. ⋯ The embryology and physiology of a left sided SVC is reviewed, including an historical perspective. A discussion of the variants of the syndrome is included, as is a review of aberrant placement of central venous catheters.
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Case Reports
Nasotracheal intubation in a child with Treacher Collins syndrome using the Bullard intubating laryngoscope.
Tracheal intubation may be difficult or impossible in children with Treacher Collins syndrome. Nasotracheal intubation may be required for appropriate repair of cleft palate in these patients. This report describes the use of the Bullard intubating laryngoscope to facilitate nasotracheal intubation in a child with severe mandibulofacial dysplasia.
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To determine the effect of reperfusion of the grafted liver on transcranial Doppler blood flow velocity in the middle cerebral artery in humans during orthotopic liver transplantation. ⋯ MCAVm increased with reperfusion of the grafted liver. These data suggest that multiple factors--including hypercarbia, lactic acidosis, or multiple vasoactive substances released by the grafted liver--may contribute to the observed increases in MCAVm, Vs, and PI.