Journal of clinical anesthesia
-
This study aims to determine trends and predictors of acute stroke among total joint arthroplasty (TJA) patients using nationally representative data. ⋯ Despite a decline in the rate of stroke and stroke-related mortality after TJA, stroke still seems to be a major cause of in-hospital mortality. The present study outlines some risk factors for stroke after TJA. Recognition of these factors and identification of the at-risk patients may allow for appropriate allocation of resources and ability to minimize this complication after TJA.
-
Case Reports
Successful recovery after amniotic fluid embolism in a patient undergoing vacuum-assisted vaginal delivery.
Amniotic fluid embolism (AFE) is a rare, catastrophic emergency that requires prompt recognition and treatment. Despite early recognition and supportive therapy, the morbidity and mortality remain high. We report a case of AFE after vacuum-assisted vaginal delivery resulting in hemodynamic collapse and subsequent multiorgan failure. ⋯ The patient was able to make a full recovery with minimal sequelae. In AFE with multiorgan failure, extracorporeal membrane oxygenation and continuous veno-venous hemodialysis can be valuable therapies. Proper management requires effective communication and the combined efforts of physicians of several disciplines.
-
The prevalence of anesthesiology department wellness programs is unknown. A database of wellness programs is needed as a resource for departments attempting to respond to the Accreditation Council for Graduate Medical Education Anesthesiology Milestones Project. The purpose of this study was to survey academic anesthesiology chairs on wellness issues, characterize initiatives, and establish wellness contacts for a Wellness Initiative Database (WID). ⋯ The majority of chairs needed to recently refer a department member to wellness resources or counseling. Most were interested in participating in a WID, whereas a minority had gauged staff interest in wellness topics or had a wellness resource repository. Highest interest was in topics most related to function as an anesthesiologist. Those willing to participate in the database had statistically significant differences in interest across most wellness topics.
-
Letter Case Reports
Intraoperative cardiovascular collapse in a patient with epidermolysis bullosa.
-
Case Reports
Iterative epidural blood patch for recurrent spontaneous intracranial hypotension during pregnancy.
A 30-year-old woman at 28 weeks presented with sudden onset of intense headache, epigastric pain, hot flushes, nausea, vomiting, and stiff neck. Cerebral magnetic resonance imaging showed pathognonomic signs of spontaneous intracranial hypotension (SIH). ⋯ SIH is a rare entity during pregnancy which may be diagnosed using magnetic resonance imaging. Iterative Epidural blood patch should be proposed to patients with SIH during pregnancy because it allowed faster symptoms improvement and patient relief with complete recovery than medical treatment only.