Anaesthesia
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Bleeding caused by inhibitors to factor VIII is a rare medical emergency requiring immediate specialist investigation and management. Urgent initiation of therapy with high dose factor VIII concentrates may be life saving. Successful management of acute upper airway obstruction from uncontrolled haemorrhage into the oropharyngeal tissues should be achieved with fibreoptic guided nasotracheal intubation.
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Case Reports
The use of a non-invasive method to measure intrapulmonary shunt during one-lung anaesthesia.
The Non Invasive Virtual Shunt computer program has previously been described and validated. The system has subsequently been developed to give a real time, continuous trace of virtual shunt. ⋯ The equipment was used to monitor shunt before, during and after surgery in three patients. In one case, a displaced double lumen bronchial tube was detected before there was any other indication of the problem.
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Arteriovenous fistulae originating from the vertebral artery are rare. We report a patient in whom a vertebral artery-jugular venous fistula developed following insertion of a central venous catheter via the internal jugular vein. The fistula was successfully occluded surgically.