Journal of clinical anesthesia
-
Comparative Study
Point-of-care viscoelastic testing improves the outcome of pregnancies complicated by severe postpartum hemorrhage.
Study Objective. To compare the clinical outcomes of patients with severe postpartum hemorrhage (PPH) managed with and without the use of Point-of-Care Viscoelastic Testing (PCVT) to direct blood product replacement. Design. ⋯ Among patients who gave birth within 24 hours of admission, the direct cost of hospitalization was 40% lower for patients in the PCVT cohort. Conclusions. PCVT-based goal-directed blood product replacement management was associated with substantial benefits over a standardized massive transfusion protocol both in terms of patient outcomes and cost of care.
-
Letter Comparative Study Clinical Trial
Clinical effects of prophylactic use of phentolamine in patients undergoing pheochromocytoma surgery.
-
Letter Case Reports
Anesthetic management for laparoscopic sleeve gastrectomy to a child.
-
Letter Case Reports
Takotsubo cardiomyopathy complicating thoracoabdominal aortic aneurysm repair.
We describe the management of a patient with symptomatic spinal cord hypoperfusion after thoracoabdominal aortic aneurysm repair, where the neurological insult and associated emotional stress precipitated Takotsubo cardiomyopathy. Transthoracic Echocardiography showed akinetic mid and apical left ventricular segments, while basal segments were spared. ⋯ Excess catecholamines have been postulated as a contributing mechanism to the disease, therefore, catecholamines were avoided to prevent further myocardial injury. Takotsubo cardiomyopathy is associated with serious morbidity and mortality, which highlights the importance of early recognition and proper management for complete recovery of both cardiac and neurologic functions.