Malignant Hyperthermia In A Child Submitted To Urgent Surgery
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| Author | : Ana Luiza da |
| Publisher | : |
| Total Pages | : |
| Release | : 2017 |
| Genre | : |
| ISBN | : |
Background: Malignant hyperthermia (MH) is a hypermetabolic syndrome, with incidence of 1:15000, that occurs in susceptible individuals primarily by the use of the volatile inhalation anesthetic agents and the succinylcholine muscle relaxant. The aim of this case report is to discuss the malignant hyperthermia confirmed by familiar muscle biopsy.Case Report: Female, 5 years old, 20Kg, ASA I, was submitted to appendectomy under balanced general anesthesia, maintenance with sevoflurane. She evolved with tachycardia and increased end-tidal carbon dioxide (EtCO2=99 mmHg). Sevoflurane administration was stopped and manual ventilation was initiated with mapleson D and FiO2 100%. The gasometry indicated paCO2=84.2 mmHg and pH=7.031. Dantrolene sodium 2.5 mg/kg was initiated and required 2 cycles. The patient presented tachyarrhythmia and evolved to bradycardia and cardiorespiratory failure. Cardiopulmonary resuscitation had to be provided. The second gasometry indicated pH=7.43 and paCO2=30 mmHg. After all, the patient was maintained with continuous infusion of dantrolene for 48 hours. She awaits the possibility of muscle biopsy and after the parentsu2019 investigations, her father was tested positive for caffeine-halothane muscular contracture test.Discussion:The hypermetabolism in MH causes an increase of carbon dioxide production, metabolic and respiratory acidosis, accelerated oxygen consumption, heat production, activation of the sympathetic nervous system, hyperkalemia, disseminated intravascular coagulation, and multiple organ dysfunction and failure. It is induced by an abnormal regulation of ryanodine receptors, producing a massive release of calcium in the sarcoplasmic reticulum of the striated muscle. The most frequent early clinical signs of MH include an increase of end-tidal carbon dioxide, tachycardia, muscle rigidity, tachypnea, and hyperkalemia.Learning points: Dantrolene sodium is the antidote that decreases the loss of calcium from the sarcoplasmic reticulum in the skeletal muscle and restores normal metabolism. The challenges of the treatment of the MH are the difficulty of dilution of the dantrolene and the needs for diagnostic confirmation with muscle biopsy that is dependent of the time of muscle recovery, child weight and the parentsu2019 diagnosis investigation.
| Author | : Manju N Gandhi |
| Publisher | : JP Medical Ltd |
| Total Pages | : 634 |
| Release | : 2011-07 |
| Genre | : Medical |
| ISBN | : 9350250705 |
There is a large influx of trauma, general surgical, pediatric, neurosurgical and obstetric emergencies as the hospital is one of the major public hospitals located in a densely populated region sitting amidst major routes in the city. It also provides services for emergency cardiovascular, cerebrovascular interventions and cadaver transplants. Daily lessons from this tremendous emergency work inspired us to bring out this book. There is plethora of reference material available in basic sciences related to anesthesiology, namely physiology, pharmacology, physics and anatomy. Similarly, a large number of textbooks are on techniques such as general, regional, monitored anesthesia care as well as super specialties like cardiac, neurosurgical and pediatric anesthesia, etc. But there is a limited availability of books and references for emergency anesthesia. One has to scan and integrate parts from various sources. This book is an attempt to assimilate the scattered information and add clinical expertise. Contents of this book have been divided into nine sections to cover majority of the emergencies. General considerations for adults, obstetric and pediatric sections have been written separately to avoid duplication. An additional challenge is cases with various medical disorders for emergency surgeries. Efforts have been taken to accommodate them in first section and obstetric section. The contributors of this book work together at LTMMC and LTMGH and have a well-balanced team with fresh talent bringing the latest technological knowledge and tenured practitioners supplementing it with applied experience. Part of the team worked on collection of the matter from different sources for an ideal scenario, while the senior faculty members used their vast clinical experience for a more practical and realistic application. These combined efforts have been truly beneficial to achieve our goal to rationally mix latest technology with clinical experience and identify potential ways to conduct anesthesia with best results, at least costs and minimum risk.
| Author | : Forrest "Dell" Moore |
| Publisher | : John Wiley & Sons |
| Total Pages | : 1191 |
| Release | : 2018-03-02 |
| Genre | : Medical |
| ISBN | : 1119317959 |
A unique question-and-answer book for surgical residents and trainees that covers all surgical aspects of critical care and acute or emergency medicine This is a comprehensive, one-of-a-kind question-and-answer text for medical professionals and apprentices concentrating on the growing subspecialty of surgery in critical care and emergency surgery. Covering all surgical aspects of critical care and acute or emergency surgery, it is an ideal learning and review text for surgical residents and trainees who care for these patients and those taking the Surgical Critical Care Board Examination. Edited by highly experienced professionals, and written in an engaging style, Surgical Critical Care and Emergency Surgery: Clinical Questions and Answers focuses exclusively on the unique problems and complexity of illnesses of the critically ill and injured surgical patient, and covers the specialist daily care such patients require. It reflects the latest advances in medical knowledge and technology, and includes fully revised and updated questions throughout, with additional topics addressed in a new companion website. Unique question-and-answer book on the growing specialty of critical care and acute surgery Ideal for US boards candidates Covers trauma and burns as well as critical care 8 page full-color insert showing high quality surgical photos to aid study Supplementary website including additional questions Surgical Critical Care and Emergency Surgery, Second Edition is an excellent resource for medical students, residents, fellows, and surgeons, as well as those in non-surgical specialties.
| Author | : Bashar Katirji |
| Publisher | : Springer Science & Business Media |
| Total Pages | : 1565 |
| Release | : 2013-10-11 |
| Genre | : Medical |
| ISBN | : 1461465672 |
Comprehensive, thoroughly updated, and expanded, Neuromuscular Disorders in Clinical Practice, Second Edition encompasses all disorders of the peripheral nervous system, covering all aspects of neuromuscular diseases from diagnosis to treatment. Mirroring the first book, this two-volume edition is divided into two parts. Part one discusses the approach to neuromuscular disorders, covering principles and basics, neuromuscular investigations, and assessment and treatment of neurological disorders. Part two then addresses the complete range of specific neuromuscular diseases: neuronopathies, peripheral neuropathies, neuromuscular junction disorders, muscle ion channel disorders, myopathies, and miscellaneous neuromuscular disorders and syndromes. Neuromuscular Disorders in Clinical Practice, Second Edition is intended to serve as a comprehensive text for both novice and experienced practitioners. General neurologists as well as specialists in neuromuscular medicine and trainees in neuromuscular medicine, clinical neurophysiology and electromyography should find this book inclusive, comprehensive, practical and highly clinically focused. Additionally, specialists in physical medicine and rehabilitation, rheumatology, neurosurgery, and orthopedics will find the book of great value in their practice.
| Author | : Bruno Bissonnette |
| Publisher | : PMPH-USA |
| Total Pages | : 2286 |
| Release | : 2014-05-14 |
| Genre | : Medical |
| ISBN | : 1607952130 |
No longer merely a subspecialty, pediatric anesthesia is now a professional entity in its own right, as is amply demonstrated in this comprehensive addition to the medical and surgical literature. Pediatric Anesthesia: Basic Principles-State of the Art-Future comprises the contributions of 150 experts in the field from all over the world, providing this book with a truly global perspective. This textbook will help anesthesiologists already interested in pediatric anesthesia to the knowledge and skills inherent to the safe practice of anesthesia for infants and children.
| Author | : Charles Vacanti |
| Publisher | : Cambridge University Press |
| Total Pages | : 1191 |
| Release | : 2011-07-11 |
| Genre | : Medical |
| ISBN | : 1139498401 |
The clinical practice of anesthesia has undergone many advances in the past few years, making this the perfect time for a new state-of-the-art anesthesia textbook for practitioners and trainees. The goal of this book is to provide a modern, clinically focused textbook giving rapid access to comprehensive, succinct knowledge from experts in the field. All clinical topics of relevance to anesthesiology are organized into 29 sections consisting of more than 180 chapters. The print version contains 166 chapters that cover all of the essential clinical topics, while an additional 17 chapters on subjects of interest to the more advanced practitioner can be freely accessed at www.cambridge.org/vacanti. Newer techniques such as ultrasound nerve blocks, robotic surgery and transesophageal echocardiography are included, and numerous illustrations and tables assist the reader in rapidly assimilating key information. This authoritative text is edited by distinguished Harvard Medical School faculty, with contributors from many of the leading academic anesthesiology departments in the United States and an introduction from Dr S. R. Mallampati. This book is your essential companion when preparing for board review and recertification exams and in your daily clinical practice.
| Author | : Michel Merle |
| Publisher | : Elsevier Health Sciences |
| Total Pages | : 544 |
| Release | : 2016-08-09 |
| Genre | : Medical |
| ISBN | : 0323481728 |
The 4th edition of the globally bestselling Chirurgie de la Main is made available to the English-speaking population for the first time in Emergency Surgery of the Hand. The text synthesizes the most current knowledge in hand surgery, emergency, and surgical principles for today's surgeons and fellows. Edited by internationally recognized experts Michel Merle and Gilles Dautel, Emergency Surgery of the Hand includes an abundance of illustrations, photographs, and step-by-step descriptions to ensure the best possible outcomes for each unique patient scenario. Provides coverage of today's hot topics in hand surgery, including free tissue transfer and pedicle flaps, as well as emergency care of infections. Prioritizes surgical techniques that allow rapid return to work. Covers the latest information on surgical principles, relevant anatomy and physiology, surgical techniques, outcomes and rehabilitation. Step-by-step descriptions of surgical procedures are enhanced by crisp, clear surgical photographs and illustrations.
| Author | : Luanne Linnard-Palmer |
| Publisher | : F.A. Davis |
| Total Pages | : 869 |
| Release | : 2016-09-30 |
| Genre | : Medical |
| ISBN | : 0803658435 |
Finally! A new OB/peds textbook that focuses on what LPNs must know. You’ll find just the right depth and breadth of coverage with a focus on the knowledge and skills that LPNs need to know to practice safely.
| Author | : Charles J. Cote |
| Publisher | : Elsevier Health Sciences |
| Total Pages | : 1192 |
| Release | : 2018-01-04 |
| Genre | : Medical |
| ISBN | : 0323551629 |
Covering everything from preoperative evaluation to neonatal emergencies to the PACU, A Practice of Anesthesia in Infants and Children, 6th Edition, features state-of-the-art advice on the safe, effective administration of general and regional anesthesia to young patients. It reviews underlying scientific information, addresses preoperative assessment and anesthesia management in detail, and provides guidelines for postoperative care, emergencies, and special procedures. Comprehensive in scope and thoroughly up to date, this 6th Edition delivers unsurpassed coverage of every key aspect of pediatric anesthesia.
| Author | : Charles J. Coté |
| Publisher | : Elsevier Health Sciences |
| Total Pages | : 1194 |
| Release | : 2009-01-01 |
| Genre | : Medical |
| ISBN | : 1416031340 |
Provide optimal anesthetic care to your young patients with A Practice of Anesthesia in Infants and Children, 5th Edition, by Drs. Charles J. Cote, Jerrold Lerman, and Brian J. Anderson. 110 experts representing 10 different countries on 6 continents bring you complete coverage of the safe, effective administration of general and regional anesthesia to infants and children - covering standard techniques as well as the very latest advances. Find authoritative answers on everything from preoperative evaluation through neonatal emergencies to the PACU. Get a free laminated pocket reference guide inside the book! Quickly review underlying scientific concepts and benefit from expert information on preoperative assessment and anesthesia management, postoperative care, emergencies, and special procedures. Stay on the cutting edge of management of emergence agitation, sleep-disordered breathing and postoperative vomiting; the use of new devices such as cuffed endotracheal tubes and new airway devices; and much more. Familiarize yourself with the full range of available new drugs, including those used for premedication and emergence from anesthesia. Benefit from numerous new figures and tables that facilitate easier retention of the material; new insights from neonatologists and neonatal pharmacologists; quick summaries of each chapter; and more than 1,000 illustrations that clarify key concepts. Access the entire text online, fully searchable, at www.expertconsult.com, plus an extensive video library covering simulation, pediatric airway management, burn injuries, ultra-sound guided regional anesthesia, and much more; and new online-only sections, tables and figures.
