Journal of clinical anesthesia
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To evaluate the clinical use of a new ECG-guided central venous catheter with regard to positioning in the superior vena cava (SVC). ⋯ Use of this wire-conducted intravascular ECG signal is a reliable tool for positioning the central venous catheter via various insertion sites. The technique proved to be an inexpensive, easy, and clear method. When a p-atriale is seen, uncomplicated insertions do not require radiologic guidance to control catheter tip position.
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A case of a hemothorax that occurred after thoracic epidural anesthesia is described. This situation might have been caused by accidental puncture of the intercostal vessel and visceral pleura by a Tuohy needle. The risk of causing a pneumothorax and/or hemothorax must be kept in mind when attempting thoracic epidural anesthesia.
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Review Case Reports
Administration of high-dose aprotinin during nonprimary cardiovascular surgery: case reports and review of the literature.
The perioperative management of two patients undergoing complex "redo" cardiac surgical procedures are presented. The management of both patients included the prophylactic administration of aprotinin via a "compassionate use" protocol. ⋯ In late December 1993, the Food and Drug Administration approved aprotinin for administration to cardiac surgical patients considered at high risk for post-cardiopulmonary bypass coagulopathies. Indications for the administration of aprotinin, as well as a brief review of the literature relating to the perioperative administration of aprotinin, are included.