Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0344329 (collapse)
 28,634 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A case report is presented of a parturient who suffered severe hypotension and pulmonary oedema following an overdose of intramyometrial prostaglandin F2 alpha. Oxytocin induction of labour in this patient led to a rapid delivery, followed by a hypotonic uterus and postpartum haemorrhage. After resuscitation with blood and crystalloid fluids, the uterus was explored under general anaesthesia. The uterus was free of retained products but the lower uterine segment failed to contract despite bimanual uterine compression and intravenous oxytocin. Prostaglandin F2 alpha was injected into the lower uterine segment via a transvaginal approach. This was rapidly followed by cardiovascular collapse and later by pulmonary oedema. The differential diagnosis and subsequent management are discussed.
 ...
PMID:Cardiovascular collapse following an overdose of prostaglandin F2 alpha: a case report. 278 38

This report describes six episodes of cardiovascular collapse in the perioperative period of a young diabetic woman undergoing general anaesthesia for renal transplantation and a similar episode after a second anaesthetic. She was subsequently found to have an autonomic neuropathy. Recommendations for the management of similar patients are made.
 ...
PMID:Renal transplantation and diabetic autonomic neuropathy. 279 Nov 81

Anesthetic technique in surgery for pheochromocytoma presents well recognized difficulties. Major complications (hypertensive crises, rhythm disturbances, collapse, pulmonary edema and hypoglycemia) can often be avoided by a good preoperative examination and full per-operative monitoring. The choice of drugs during anesthesia and per-operative resuscitation are discussed in this article together with particular situations such as pheochromocytoma in pregnancy or the per-operative discovery of a previously unrecognized pheochromocytoma.
 ...
PMID:[Anesthesia and resuscitation in surgery of pheochromocytoma]. 279 43

A 27-years-old man was admitted for correction of nasal fracture. He presented with circulatory collapse and generalised erythema on induction of general anesthesia and during preparation of intradermal test for identifying the offending agent. As both of these responses occurred during intravenous infusion of lactated Ringer's solution with 5% maltose, anaphylactoid responses to this intravenous solution were strongly suspected.
 ...
PMID:[A case of anaphylactoid reactions to lactated Ringer's solution with 5% maltose]. 281 Jul 20

Three patients due to be operated by caesarean section under regional anaesthesia developed severe hypotension/circulatory collapse. The sympaticus blockade induced by epidural-/spinal anaesthesia aggravates the effect of aortocaval compression present in all pregnant women at term. We discuss prophylactic measures and treatment of hypotension.
 ...
PMID:[Severe hypotension in cesarean section. Aortocaval compression and regional anesthesia]. 281 39

Carcinoid syndrome produces flushing, bronchoconstriction and gastrointestinal hypermotility secondary to serotonin, histamine, bradykinin and prostaglandin release. A variety of drugs, foods and anaesthetic agents may provoke this syndrome. Under anaesthesia, the flushing produced may be associated with acute hypotension and cardiovascular collapse; this phenomenon is called a carcinoid crisis. Recently, somatostatin analogue has been used successfully to treat intraoperative carcinoid crisis. In this report, we present a 66-year-old lady with carcinoid syndrome who was pre-treated with 50 micrograms somatostatin analogue IV and IM prior to surgical manipulation. The anaesthetic course was relatively uneventful and the patient did well postoperatively.
 ...
PMID:Pre-treatment with somatostatin in the anaesthetic management of a patient with carcinoid syndrome. 290 85

Twenty-one compartment syndromes of the thigh in seventeen patients were identified for retrospective review. Ten of the compartment syndromes were associated with an ipsilateral femoral fracture; five of these femoral fractures were open. In five patients, the syndrome followed femoral intramedullary stabilization. The remaining eleven syndromes followed blunt trauma to the thigh, prolonged compression by body weight, or vascular injury. The patients who were awake and alert at the time of the examination complained of intense pain in the thigh, and they had neuromuscular deficits. For the patients who could not cooperate with a subjective physical examination because they were under general anesthesia or because of associated injuries, the measurement of compartment pressure assumed a more important diagnostic role. All of the patients had tense swelling of the involved thigh. The predisposing risk factors for the development of compartment syndromes of the thigh, which are common in the multiply injured population, include: systemic hypotension, a history of external compression of the thigh, the use of military antishock trousers, coagulopathy, vascular injury, and trauma to the thigh, with or without a fracture of the femur. In approximately one-half of these patients, a crush syndrome developed, with myoglobinuria, renal failure, and collapse of multiple organ systems. Eight patients (47 per cent) died as a result of multiple injuries. Of the nine patients (ten compartment syndromes) who survived, infection developed at the site of the fasciotomy in six. Follow-up examination revealed marked morbidity, including sensory deficit and motor weakness of the lower extremity.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Acute compartment syndrome of the thigh. A spectrum of injury. 292 12

Sixty eight adults of both sexes (33 patients with clinically and endoscopically verified tracheobronchial collapse; 35 persons without disease of the central airways) underwent continuous cinetracheographic studies of the wall-movements of the central airways during various respiratory maneuvers. The insufflation of powdered tantalum for a better outlining of the contours of the central airways was preferably done in local anaesthesia via an orotracheally inserted catheter. Studies of wall-movement were made in recumbent position during forced breathing and violent coughing in various obliquities using a 35 mm-camera. The percentage of diameter-shortening during expiration (forced breathing; violent coughing) in relation to the inspiratory diameter during the same breathing-maneuver was measured in 4 or 3 projections respectively at 5 localities (cervical trachea; thoracic outlet; thoracic trachea 1 cm above the bifurcation; right and left main bronchus, 1 cm distant from bifurcation). Out of maximally 17 single numerical values per examination the highest single value was selected as the so-called "maximal relative diameter-shortening" - independent of locality and projection. In healthy persons the mean value amounts to 22.4 +/- 15.44% (means +/- SD) during forced breathing and to 75.5 +/- 11.72% during violent coughing. Patients with a tracheobronchial collapse differ from healthy persons, the former having a value of 100% during violent coughing. This is equivalent to a brief contact of the membranous part to the ventral circumference of the trachea (total cough-collapse) at least at one locality in one projection. Out of a number of 28 patients 17 cases (group H) revealed a normal "maximal relative diameter-shortening" of 29.7 +/- 21.57% during forced breathing. In addition to the total cough-collapse 11 patients (group F) exhibited an increased prolapse-tendency of the membranous part during forced breathing, too; the mean value of the "maximal relative diameter-shortening" amounted to 80.5 +/- 16.15%. Pathological shortening-values are mainly measured at the intrathoracic trachea in the lateral and both oblique projections. The cinetracheobronchographic examination should be used in patients with endoscopic signs of a tracheobronchial collapse-syndrome if an operative procedure with tautening is taken into consideration. In the case of mere clinical suspicion of the presence of a collapse-syndrome the assessment of the wall-motility is non-invasively possible by means of cinetracheography without a contrast-agent.(ABSTRACT TRUNCATED AT 400 WORDS)
 ...
PMID:[Comparative cinematographic, endoscopic and functional analytic studies of the pre- and postoperative evaluation of the severity of the tracheobronchial collapse syndrome]. 292 61

Calcium blockers (CB) are routinely used. This could lead to possible interference with anaesthetic drugs. CB prevent calcium from entering the cell by inhibiting the slow voltage-dependent calcium channels. They act mostly on heart and smooth muscle. Of all the possible indications, the three that are confirmed are coronary heart disease, arterial hypertension and supraventricular rhythm disturbances. Most of the work published and the cases reported concerns interactions between CB and halogenated anaesthetic agents; the latter's actions on the heart depend on cellular calcium exchange. Also, the cardiovascular effects of these anaesthetics are similar to that of CB. Experimentally, halothane and enflurane have direct cardiac inhibitory effects similar to verapamil and diltiazem, whereas isoflurane's properties seem closer to the dihydropyridines (nifedipine and nicardipine). Giving verapamil or diltiazem increases the number of sino-atrial and atrio-ventricular blocks when using a halogenated agent. Clinically, interpreting the effects of CB during anaesthetic induction is difficult because of the pathology (coronary heart disease, cardiac failure), the other drugs (beta-blockers and nitrates) and the type of anaesthesia (emergency or elective). Interactions can give rise to anything from a severe cardiovascular collapse, requiring catecholamines, to a mild fall in blood pressure which responds well to plasma expansion, or even no effect on blood pressure. Rebound is seen on stopping CB in patients with coronary heart disease or arterial hypertension; stopping them before surgery does not therefore seem justified. However, extreme care must be taken when using halogenated agents for patients under treatment with CB and/or beta-blockers. A wary anaesthetist will be able to adapt the technique to the patient. It has been suggested that CB could be used to treat preoperatively myocardial ischaemia (diltiazem), hypertensive crises (nifedipine, nicardipine) and ventricular rhythm disturbances (verapamil); this must be done with caution, the patient being closely monitored (haemodynamic and electrocardiographic monitoring). Postoperatively, intranasal nifedipine, continuous intravenous nicardipine or diltiazem have been used to treat increases in arterial blood pressure during recovery and to adapt the cardiovascular system to the increased metabolic needs. Here again, close patient monitoring is essential. In any case, treatment with CB which has been stopped should be started up again as soon as possible.
 ...
PMID:[Calcium inhibitors and anesthesia]. 297 26

Bupivacaine and chloroprocaine have proven to be valuable local anesthetics for a variety of surgical and obstetrical situations. Bupivacaine is particularly useful as a long acting agent which provides excellent sensory analgesia particularly during labor with minimal blockade of motor fibers. The 0.75% solution is useful for epidural surgical anesthesia since it does result in a decrease in onset time and a more marked motor blockade. In recent years, this agent has been reported to cause rapid cardiovascular collapse in some patients. Cardiotoxicity associated with bupivacaine is related not to the concentration employed but to the total dosage administered as a rapid intravenous injection. The careful administration of this agents to avoid an accidental intravenous injection should not preclude the use of 0.75% bupivacaine for epidural anesthesia in surgical patients. This concentration is not recommended in obstetrical cases. Chloroprocaine is valuable as a rapid onset, short duration local anesthetic with a low potential for systemic toxicity. The 3% solution is particularly useful for providing a rapid onset of action. In recent years, localized neural irritation has occurred in some patients in whom large amounts of this agent were administered epidurally or intrathecally. The local neural toxicity of chloroprocaine solutions is referably to the low pH and the inclusion of sodium bisulfite in these particular solutions. The toxicity of chloroprocaine solutions is related to total dosage rather than the concentration of solution employed. Careful administration of chloroprocaine epidurally in order to avoid accidental subarachnoid injection should preclude the possibility of local neural toxicity.
 ...
PMID:Is there a need for chloroprocaine 3% and bupivacaine 0.75%? 305 87


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>