Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Case Reports
Continuous haemodiafiltration during and after cardiopulmonary bypass in renal failure patients.
Continuous haemodiafiltration (CHDF) is a technique enhancing the efficiency of solute clearance of haemofiltration by infusing dialysis fluid through the haemofilter. It has been reported to control water and electrolyte balance continuously without haemodynamic instability in critically ill patients with renal failure, Therefore, we used CHDF during and after cardiopulmonary bypass (CPB) in two renal failure patients, and discuss its efficacy. ⋯ Our initial experiences of CHDF during and after CPB suggest that the technique provides excellent electrolyte, metabolite and fluid management for the cardiac patients with chronic renal failure. Combined with nafamostat mesilate for anticoagulation, CHDF was simple and safe and did not increase the risk of bleeding.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of rocuronium and d-tubocurarine for prevention of succinylcholine-induced fasciculations and myalgia.
We compared d-tubocurarine and rocuronium for the prevention of succinylcholine-induced fasciculations and postoperative myalgia (POM) and evaluated the influence of both drugs on the speed of onset and recovery of succinylcholine. ⋯ Rocuronium prevents succinylcholine-induced fasciculations and POM. Rocuronium also delays the onset of succinylcholine and shortens its duration compared with d-tubocurarine.
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Randomized Controlled Trial Clinical Trial
Prostaglandin E1, lidocaine, and prostaglandin E1-lidocaine combination for attenuating cardiovascular responses to extubation.
Tracheal extubation produces haemodynamic changes that may cause myocardial ischaemia in patients with coronary arterial disease. Intravenous infusion of prostaglandin E1 (PGE1) attenuated the hypertensive response to tracheal extubation but failed to blunt the tachycardia, which was attenuated by intravenous lidocaine. Thus, we investigated whether a combination of PGE1 and lidocaine can overcome the drawbacks of treatment with PGE1 alone. ⋯ The combination of PGE1 infusion and lidocaine is a more effective method of attenuating hypertension and tachycardia associated with tracheal extubation than either drug alone.
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To evaluate the onset of vecuronium neuromuscular blockade in the hand with an arterio-venous shunt for haemodialysis. ⋯ The presence of an arteriovenous fistula does not modify the onset on neuromuscular blockade. Either arm can be used to monitor onset of neuromuscular blockade in chronic renal failure patients with an arterio-venous shunt in the hand for haemodialysis.
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A first case of massive venous air embolism is reported as a complication of orthotopic liver transplantation in a 17-month-old child during the dissection phase. ⋯ Venous air embolism during the dissection phase of liver transplantation in children is a risk that should be considered