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  • ISSN: 2333-6641
    Volume 2, Issue 4
    Review Article
    Antonella Carsana*
    Abstract:
    Sequence variations in the RYR1 gene encoding the skeletal muscle sarcoplasmic reticulum calcium release channel are the cause of malignant hyperthermia susceptibility and of several myopathies. This article reviews the RYR1-related myopathies and their association with malignant hyperthermia susceptibility, a life-threatening anesthetic complication which is avoidable if anticipated pre-surgically. This is especially important for counseling and improving patient safety during anesthesia, in particular for asymptomatic relatives of patients with recessive RYR1-related myopathies.
    Herway ST* and Benumof JL
    Abstract:
    The length of the human trachea in both awa-e and anesthetized and paralyzed patients is a critical consideration in preventing both endobronchial intubation and tracheal extubation. It is clear from the literature that with the dynamic clinical changes that occur under anesthesia, including the assumption of the supine position, head and nec- flexion and extension, pneumoperitoneum, and Trendelenburg positioning, the trachea acts as an accordion decreasing and increasing its length. -nowledge of the magnitude of the change in tracheal dimensions in response to these factors is an important clinical consideration.
    Case Report
    Saurabh Jain1*, Avneesh Khare2, Shobha Purohit2 and RS Mittal1
    Abstract:
    Management of sphenoid wing meningioma is a big challenge not only for the neurosurgeon, for the anesthesiologist also. It requires extensive preoperative work up and assesement, on toe intraoperative monitoring with quick response skills and effective postoperative care.
    The issue becomes more complicated when it was associated with some associated comorbid condition like valvular heart disease compromising cardiovascular reservoirs of the individual.
    Here we are discussing a patient of medial sphenoid wing meningioma with mitral stenosis with mitral regurgitation not in failure.
    Research Article
    Shannon M. Grap1, Micheal Goldenberg1, Colin Huntley2, Kane High1, Margaret M. Wojnar1, Eric W. Schaefer1 and Sonia Vaida1*
    Abstract:
    Background: Tracheostomy is a common surgical procedure performed in the adult intensive care unit (ICU) population. Our objective was to identify characteristics associated with one year mortality in adult ICU patients following tracheostomy placement.
    Methods: A retrospective chart review was conducted on adult ICU patients admitted at Penn State Hershey Medical Center between January 2004 and December 2009 (n=193) who had a first time tracheostomy. Using univariate statistical analysis with logistic regression and Bonferonni correction, the significance of individual characteristics to one year mortality following tracheostomy was determined. Statistical significance was considered p< 0.05; all p values reported are Bonferonni-corrected values.
    Results: Mortality at one year following tracheostomy was 21.2% (41 of 193 patients). A total of nine variables were found to have a statistically significant correlation with patient mortality: one week increase in continuous intravenous sedation length following tracheostomy (p=0.00057), fourteen day increase in total mechanical ventilation length (p=0.00082), hyperglycemia (p=0.00130), continuous intravenous vasopressor medication infusions during tracheostomy (p=0.00222), acute renal failure (p=0.00471), increased age (p=0.00892), continuous intravenous vasopressor medication infusions during ICU stay (p=0.01711), hemodialysis (p=0.02813), and a 10,000 cell/μL increase in peak white blood cell count (p=0.03574).
    Conclusions: Clinical factors associated with increased mortality of adult ICU patients one year following tracheostomy were identified. These factors may indicate greater severity of systemic dysfunction in an already critically ill population leading to increased mortality..
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