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Query: UMLS:C0344329 (collapse)
 28,634 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Circulatory collapse is known to occur during cementation of hip arthroplasty. The pathogenesis is multifarious, but the most important cause is believed to be formation of air embolism during insertion and cementation of the femoral component followed by air embolism in the heart. Inserting the cement retrogradely with a cement gun following distal plugging of the femoral cavity with spongiosa and using a plastic catheter for suction drainage reduces the air embolisation. Cement producing as little heat as possible during the setting should be used. Maintaining anaesthesia with N2O air embolism and should be avoided during and after cementation. Pre- and intraoperative care of the patient's circulation and oxygenation is essential. The use of pulse oximetry, capnography and precordially recorded Doppler ultrasound are recommended for monitoring air embolism.
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PMID:[Intraoperative complications during cementation of hip arthroplasty. Avoiding air embolization during cementation]. 150 58

Two operative cases of emphysematous giant bullae of the lung accompanied with bronchial asthma were reported. Case 1: A 41-year-old man suffering from dyspnea and fever-up was diagnosed as emphysematous giant bullae of the right lung accompanied with severe bronchial asthma. Preoperative examination revealed severe hypoxemia (PO2 46 mmHg) and mixed type ventilatory disorder; VC 1.68 t (41%), FEV1.0 0.59 l (35%). On the first anesthesia, operation was postponed by the severe asthmatic attack and circulatory collapse. After the complete prevention of the attack by giving corticosteroid (25 mg/day) for two weeks, resection of giant bullae could be performed safely. Case 2: A 31-year-old man complaining wheeze was diagnosed as emphysematous giant bullae of bilateral upper lobes of lung accompanied with bronchial asthma. Preoperative and intraoperative states were uneventful, though, on the day after the operation, asthmatic attack occurred due to the difficulty in expectation of sputa. It took 12 hours and many kinds of drugs to improve the respiratory state. In the patients of bronchial asthma, preoperative sufficient suppression of hyperreactivity of airway tracts and postoperative careful treatment to avoid asthmatic attack seem to be indispensable.
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PMID:[Surgical treatments of emphysematous giant bullae accompanied with severe bronchial asthma]. 151 3

A healthy young woman suffered cardiac arrest during diagnostic laparoscopy; emergent laparotomy was required to release the pneumoperitoneum and reinitiate cardiac rhythm. Several cases of cardiovascular collapse have been described in the literature. Possible causes for such complications include hypercapnia or anoxia from hypoventilation during anesthesia, decreased venous return and cardiac output secondary to elevated intra-abdominal pressure, gas embolism, and a profound vagal response to peritoneal distention. Treatment includes cardiovascular support and rapid release of the pneumoperitoneum.
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PMID:Asystolic cardiac arrest: a rare complication of laparoscopy. 153 24

A frequent dilemma facing the anaesthetist is the child with respiratory tract symptoms. The risks of anaesthesia and surgery in these patients have not been clearly established. We present three cases which illustrate a potentially serious complication which may arise. Our patients each had symptoms of cough, but were systemically healthy. Two of the children had absent clinical signs, whilst the third had a normal chest X ray. However, during surgery and anaesthesia each child developed significant pulmonary collapse, associated with desaturation on oximetry.
Anaesthesia 1992 May
PMID:Pulmonary collapse during anaesthesia in children with respiratory tract symptoms. 159 67

Twenty one children with asthma aged 1.0-10.5 years (mean (SD) 3.3 (2.5) years) were admitted to the hospital to evaluate pulmonary right middle lobe or lingular collapse lasting one to 12 months (mean (SD) 4.4 (3.8) months). Seven children had mild asthma and were treated with inhaled beta 2 agonists as needed. Nine had moderate asthma treated with either sodium cromoglycate or slow release theophylline. Five had severe asthma treated with inhaled steroids. Each child underwent fibreoptic bronchoscopy under local anaesthesia and a bronchoalveolar lavage. Differential cell counts of the lavage fluid revealed predominance of neutrophils in 12 patients (57%). In nine of these patients cultures grew pathogenic bacteria, mainly Haemophilus influenzae and Streptococcus pneumoniae. There was no correlation between the severity of asthma and a positive bacterial culture. There was also no correlation between the duration of the right middle lobe collapse and a positive culture. We conclude that longstanding right middle lobe collapse in asthmatic children is often associated with bacterial infection.
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PMID:Role of infection in the middle lobe syndrome in asthma. 159 94

We studied 58 patients undergoing orthotopic liver transplantation, aged 42 +/- 10 years (mean +/- SD), and weighing 65 +/- 14 kg. Anesthesia was maintained with fentanyl, midazolam, and vecuronium. Serum bicarbonate, serum potassium, serum ionized calcium and pH did not change significantly throughout the study. Usual hemodynamic parameters were recorded. Hemodynamic tolerance was assessed by a trial of clamping of the inferior vena cava, above and below the liver and the portal vein; patients were allocated to two groups: the group without venovenous bypass (NBP, n = 29) consisted of patients whose MAP did not decrease by more than 30% and/or cardiac output did not decrease by more than 50%; the group with venovenous bypass (BP, n = 29) consisted of patients whose MAP decreased by more than 30% and/or cardiac output decreased by more than 50% or required venovenous bypass for easier surgical dissection. After clamping of the vena cava and the portal vein, the cardiac index (CI) and mean pulmonary arterial pressure (MPAP) decreased significantly, whereas systemic vascular resistances (SVR) increased. After unclamping the inferior vena cava suprahepatically and infrahepatically, no hemodynamic change was observed. After unclamping the portal vein, MAP decreased, despite the increase in the CI, because of an significant decrease in SVR; in addition MPAP increased despite the decrease in pulmonary vascular resistances. The decrease in MAP of more than 30% during at least 1 min occurred in 6 patients (20%) in the NBP group and in 6 patients (20%) in the BP group. We concluded that the occurrence of the syndrome of cardiovascular collapse following liver reperfusion was similar whether venovenous bypass was used or not.
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PMID:The failure of venovenous bypass to prevent graft liver postreperfusion syndrome. 163 49

Cardiovascular collapse following intravascular bupivacaine may be resistant to treatment. The effect of amrinone on recovery from bupivacaine-induced severe cardiovascular depression was evaluated in 20 pigs (13-26 kg) in a placebo-controlled randomized double-blind study. Under 0.7% isoflurane anesthesia at FIO2 0.21, 0.5% bupivacaine 2 mg.kg-1.min-1 was infused until mean arterial pressure was 40% of the baseline. Cardiac output and heart rate decreased 75% and 50% from the baseline, respectively. The total dose of bupivacaine was 17 +/- 6 (SD) mg.kg-1 in the control and 19 +/- 5 mg.kg-1 in the amrinone group, resulting in mean plasma concentrations of 42 +/- 6 and 53 +/- 19 micrograms.ml-1, respectively. A bolus of amrinone 4 mg.kg-1 (n = 10) was given immediately after cardiovascular depression, followed by an infusion of 0.6 mg.kg-1.min-1. The control animals received corresponding volumes of physiologic saline (n = 10). After cardiovascular depression, the lungs were ventilated with FIO2 1.0 without anaesthetics or sympathomimetic support. Electric activity of the heart ceased in all control animals in 3.9 +/- 2 min after cardiovascular depression despite atropine and external cardiac compression. All animals in the control group and 5 of 10 animals in the amrinone group were given atropine (P less than 0.01). The animals receiving amrinone survived without cardiac compression (P less than 0.0001). During bupivacaine infusion, all animals developed burst suppression in the electroencephalogram. At the time of cardiovascular depression, in 8 of 10 control and in 6 of 10 amrinone animals, the electroencephalogram was isoelectric.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The effect of amrinone on recovery from severe bupivacaine intoxication in pigs. 164 51

Reports of severe life-threatening anaphylaxis to latex are increasing. A case of latex anaphylaxis occurring during surgery is reported. Sudden cardiorespiratory collapse 25 min after the start of surgery was treated with oxygen, fluid, epinephrine, hydrocortisone, and benadryl. Two months later, skin testing to latex was positive but intradermal testing to the drugs used during anaesthesia was negative. Anaesthetists should be aware of this clinical entity. Latex allergy should be considered in the differential diagnosis of intraoperative anaphylaxis. Fortunately, it is usually preventable by obtaining a positive history, recognising that it occurs in particular subsets of patients and by avoiding latex products. Skin testing to latex is available and may assist in the recognition of latex sensitivity.
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PMID:Anaesthesia and the patient with latex allergy. 164 73

A 62 year-old female developed bronchospasm after intravenous vecuronium administration. Vecuronium is reported to have major advantages over pancuronium due to the lack of significant histamine-releasing activity and cardiovascular side effects. However, macular rash, systemic collapse and bronchospasm have been reported before. The patient received cholecystectomy under general anesthesia. She had a history of urticaria when she had had a intravenous pyelography and showed positive skin test to antibiotic, ceftizoxime. During induction with thiopental plus vecuronium and on addition of vecuronium, bronchospasm was induced within five minutes in each time. Both episodes of bronchospasms were relieved with intravenous aminophylline and methylprednisolone. During the operation arterial blood gas samples were taken twice and showed no abnormal findings. Further blood samples were taken for complement C3, C4, plasma IgE and white blood cell counts. Skin test to vecuronium was also performed. In spite of these data, the mechanism of bronchospasm remained obscure. Careful attention should be paid to the use of vecuronium, especially for the patient who showed allergic response to some drugs.
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PMID:[Possible bronchospasm after administration of vecuronium]. 167 99

2 groups of patients with ectopic pregnancy (376 cases from 1947 to 1966 and 81 from 1982 to 1988) are compared. The importance of evaluation of HCG, sonography and pelviscopy, which was only available in the 2nd group, is pointed out. The morbidity by collapse of circulation could be improved. Sonography and beta-HCG serum levels each are quite sensitive but not very specific. Together they give good information. The highest specificity shows the pelviscopy, but it is an invasive method and requires anesthesia. By early diagnosis of the ectopic pregnancy in the 2nd group 50% of the patients could be treated by an operation with conservative of the fallopian tube.
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PMID:[Change in diagnosis and therapy of extrauterine pregnancy in the last 4 decades]. 169 53


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