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5 results

  • Chapter 99 - Transfusion Therapy

  • from Section 14 - Other Situations
  • Edited by Jessica A. Lovich-Sapola, Cleveland Clinic, Ohio
  • Book: Anesthesia Oral Board Review
  • Published online: 03 August 2023
  • Print publication: 24 August 2023, pp 420-424

  • Summary

    A 36-year-old G3P2 with pregnancy-induced hypertension was admitted to the hospital at 34 weeks’ gestation with a chief complaint of severe abdominal pain and tenderness. On admission she was pale, with cold and clammy skin, heart rate of 140 and blood pressure of 87/46 mm Hg. Diagnosis of suspected placental abruption was confirmed by the ultrasound. The obstetrician on call decided to proceed with an emergent cesarean delivery. What are your anesthetic concerns? What laboratory tests would you like to obtain? What additional preparations would be required? What complications are you anticipating and how do you plan to address them?

  • Case 60 - Craniosynostosisrepair

  • from Section I - Neuroanesthesia
  • Edited by George A. Mashour, Ehab Farag
  • Book: Case Studies in Neuroanesthesia and Neurocritical Care
  • Published online: 03 May 2011
  • Print publication: 03 February 2011, pp 195-198

  • Summary

    Open spine stabilization with polymethylmethacrylate (PMMA) augmentation procedures requires significant attention during anesthetic management due to the complication of PMMA embolization. This chapter presents a case study of a 54-year-old male with a T12 burst fracture presented for a second stage posterior instrumentation of T9-L4. It presents a case of hemodynamic instability due to embolization during surgery as well as its management. Myocardial ischemia, pulmonary embolism (PE) from deep venous thrombosis or PMMA, and anaphylactoid/anaphylaxis reaction were considered. This patient had osteoporosis, a systemic skeletal disease characterized by low bone mass and microarchitectural deterioration of bone tissue, with a consequent increase in bone fragility and susceptibility to fractures. Cardiopulmonary presentation is either immediate or delayed and can be catastrophic. Consider a chest X-ray, echocardiogram, and computed tomography scan as diagnostic tools. If strongly symptomatic, consult cardiothoracic surgery for possible embolectomy.