A & A case reports
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Invasive airway access by emergent cricothyrotomy remains an essential treatment modality in "can't intubate/can't ventilate" scenarios. Although numerous commercial devices are available, limited comparative data exist with regard to the ventilation and oxygenation parameters of these devices. ⋯ Because of oxygenation and ventilatory insufficiency, our patient required emergent removal of the device and surgical tracheostomy to improve respiratory function. When confronted with a difficult airway, anesthesiologists and surgeons should be aware of commonly encountered cricothyrotomy devices and their potential limitations.
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We describe the first case of a pregnant woman presenting with an acute inverted takotsubo-like cardiomyopathy caused by a postpartum diagnosed hemorrhagic pheochromocytoma, successfully treated with percutaneous venoarterial extracorporeal membrane oxygenation (va-ECMO). During admission, an emergency cesarean delivery had to be performed. ⋯ Despite advances in diagnostic techniques during the past decade, in many cases, pheochromocytoma in pregnancy is still missed. This results in a maternal and fetal mortality rate of up to 30% in both.
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Case Reports
The First Case Report of Anaphylaxis Caused by the Inclusion Complex of Rocuronium and Sugammadex.
A 50-year-old man developed a severe anaphylactic reaction shortly after the administration of sugammadex at the end of an uneventful laparoscopic appendectomy. Subsequent skin testing was negative to all agents to which the patient was exposed including sugammadex. ⋯ This is the first case report of anergy to the individual components but sensitivity to the inclusion complex of rocuronium and sugammadex. Written informed consent was obtained from the patient for skin testing, photography, laser perfusion imaging, and publication of this case report.