No abstract

Manufacturing defects in the connector of the endotracheal tube are not frequently encountered in emergency and planned intubations. In cases where they are encountered, however, they may cause partial or complete airway obstruction in sick infants with limited reserves, giving rise to a life-threatening situation following the intubation. For this reason, endotracheal tubes must be checked carefully before use. To this end, a stylet can be passed through the tube to check for a defect in the tube lumen or tube connector as part of a routine check of an endotracheal tube. This report features a patient who experienced a complete airway obstruction following intubation due to a manufacturing defect in the connector of the endotracheal tube.

No abstract

Lithium, first approved by the American Food and Drug Administration (FDA) for mania treatment in 1970, is used as the gold standard in the treatment of bipolar disorder in these days. Its neuroprotective effects, its usefulness in preventing recurrences, its property to reduce suicidal acts and thoughts have led it to be preferred against this disease.Though risperidone, one of the antipsychotic drugs, in 1994 while quetiapine in 1997 received FDA approval for the treatment of schizophrenia, these have used for the bipolar disorder treatment in recent years. Studies have shown that response and remission rates are better in combination therapies than in monotherapy for bipolar disorder. Combination therapies are applied to cases that are considered to be resistant to treatment, to the patients who give partial response, or to those who do not respond to the initial treatment. However, the main disadvantage of these treatments is that they increase the side effects. It is known that the combination of lithium with antipsychotic, antidepressant and anticonvulsant drugs is a predisposing risk factor for high lithium levels. The narrow therapeutic index of lithium also poses a potential risk of toxicity. Therefore, neurotoxic, nephrotoxic and cardiotoxic side effects of lithium on organ systems may occur. Despite these frequently preferred combination therapies, the number of case reports of severe intoxication associated with them is scarce. In this study, we aimed to discuss the effect of severe toxicity due to triple combination therapy on organ systems.

Trakea stenozu konjenital, edinsel ve idiopatik nedenlerle oluşan bir hava yolu obstrüksiyonudur. En sık görülen etiyoloji ise entübasyon veya trakeostomiye bağlı uzamış mekanik ventilasyondur. Entübasyona bağlı trakeal stenoz, endotrakeal kaf basıncının trakea mukozası ortalama kapiller-arterioler kan basıncını aşması sonucu oluşur. Girişimsel bronkoskopik yöntemler özellikle son yıllarda seçilmiş hastalarda düşük komplikasyon oranları nedeniyle hem tanı hem de tedavide kullanılmaya başlanmıştır. Özellikle genel anestezi altında uygulanan rijit bronkoskopide hızlı bir anestezi indüksiyonu ile kontrollü bir hava yolu ve ventilasyon sağlanarak güvenli bir müdahale yapılabilir. Bu makalede entübasyona bağlı trakeal stenoz gelişen dört olguda rijit bronkoskopi eşliğinde yapılan balon dilatasyon uygulamasında total intravenöz anestezi yönetimi sunulmuştur.