Journal of clinical anesthesia
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Understanding the management of the parturient with single ventricle physiology starts with knowledge of the lesion, the patient's current stage of surgical palliation, her current functional status, and the impact of pregnancy and labor on her cardiac physiology. A multidisciplinary team approach, described in this article, is crucial to a positive outcome.
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Letter Clinical Trial
Anesthesia for irreversible electroporation of hepatic malignant tumors.
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Case Reports
Difficulty in placement of a left-sided double-lumen tube due to aberrant tracheobronchial anatomy.
A rare case of a tracheal bronchus coexisting with a left-shifted carina and an acute angle of left main bronchus is presented. A 66 year old man with a history of colon cancer was scheduled for right thoracoscopic pericardial window due to recurrent pericardial effusion. After induction of anesthesia, the trachea was intubated using a 39-French, left-sided double lumen tube (DLT); the DLT was positioned with fiberoptic bronchoscopic guidance. ⋯ While repositioning the DLT, we found an aberrant tracheal bronchus. Although multiple attempts were made to adjust the DLT so as to achieve lung isolation, we could not place the DLT in the appropriate position due to abnormal and distorted anatomy. Lung isolation was unsuccessful; both lungs were carefully ventilated with small tidal volumes.
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To determine if health care providers at one district hospital in Nairobi, Kenya, possess the training and confidence necessary to attend to basic needs for patient resuscitation. ⋯ Providers of the Mbagathi District Hospital, Nairobi, report a lack of confidence in recognizing basic resuscitation needs, and they desire additional training.