Journal of neurosurgical anesthesiology
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J Neurosurg Anesthesiol · Jul 2012
Case ReportsSerial measurement of extravascular lung water and blood volume during the course of neurogenic pulmonary edema after subarachnoid hemorrhage: initial experience with 3 cases.
Neurogenic pulmonary edema (NPE) as a systemic consequence early after aneurysmal subarachnoid hemorrhage (SAH) sometimes complicates perioperative and postoperative fluid management and increases the risk of a poor outcome. This is the first report to demonstrate the ability of a bedside transpulmonary thermodilution device to trace physiological patterns consistent with current theories regarding the mechanism and course of post-SAH NPE. ⋯ Our clinical experience suggests that the present monitoring system is capable of distinguishing different etiologies for pulmonary edema complicating SAH that may assist with fluid management decisions.
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J Neurosurg Anesthesiol · Jul 2012
Awake fiberoptic intubation and self-positioning in patients at risk of secondary cervical injury: a pilot study.
This study was designed to document the feasibility of self-positioning after awake fiberoptic intubation of the trachea using primarily effective topical anesthesia rather than sedation. ⋯ Our study demonstrates that awake fiberoptic intubation and patient self-positioning was feasible in this sample of patients at risk of secondary cervical injury. This technique may extend the opportunity of continuous neurological monitoring in patients with a risk of position-related cervical injury, especially where electrophysiological monitoring is not possible or is unavailable.