Journal of clinical anesthesia
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Cardiopulmonary bypass (CPB) does not appear to cause excessive maternal risk, but the potential for fetal complications is of great concern. In general, operative intervention should be delayed until at least the second trimester. ⋯ This conflict is further complicated by maternal status changes that may accompany valvular disease or develop after CPB. The case described herein summarizes and discusses these conflicts.
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Hyskon, a distension medium composed of dextran 70 in 10% dextrose in water, is often used during hysteroscopic procedures. Coagulopathy and pulmonary edema are the most commonly reported side effects encountered during its use. We present the first case report in which a healthy patient developed pulmonary hemorrhage from Hyskon use. The major side effects of Hyskon are discussed, as are the possible etiologies of the reported complication and the implications for anesthesiologists.
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Case Reports
Cesarean section in a pregnant patient with an anterior mediastinal mass and failed supradiaphragmatic irradiation.
Nodular sclerosing Hodgkin's disease stages IA and IIA are the most common presentation of this disease during pregnancy. Patients presenting with late Hodgkin's disease with failed irradiation for cesarean section present a unique challenge. ⋯ We report a case involving a pregnant patient at 34 weeks' gestation presenting for cesarean section with a symptomatic anterior mediastinal mass occupying over 50% of the thoracic diameter. The anesthetic management was performed using continuous spinal.
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Arterial misplacement of the Swan-Ganz catheter occurs occasionally and usually can be easily detected. However, in some special clinical settings, the problem may become more complicated. We report a case of chronic obstructive pulmonary disease in which, because of severe hypoxemia, systemic hypotension, and pulmonary hypertension, conventional methods failed to recognize the misplacement, until confirmed with blood gas analysis.