Failed ventilation due to heat and moisture exchange filter malfunction: A difficult diagnostic scenario

Bajwa, Sukhminder Jit Singh; Singh, Amarjit

doi:10.4103/0970-9185.111749

Cited by 12 publications

(12 citation statements)

References 8 publications

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“…Clinicians should be able to anticipate AKI on the basis of patients’ clinical characteristics and minimize the morbidities occurring with postoperative renal failure (51). Strategies should also include modifications in the techniques of anesthesia and titration in addition to practicing renal protection techniques during perioperative period (2, 52-54). …”

Section: Discussionmentioning

confidence: 99%

Predictors of Acute Kidney Injury in Geriatric Patients Undergoing Total Knee Replacement Surgery

Sehgal¹,

Bajwa²,

Sehgal³

et al. 2014

Int J Endocrinol Metab

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Background:Few studies have focused on patients’ characteristics that affects acute kidney injury (AKI) after total knee replacement surgery (TKR).Objectives:The primary objective of this retrospective study was to identify patients’ characteristics associated with AKI after TKR.Patients and Methods:Between January 2008 and December 2009, 659 patients with a mean age of 67.1 years (range, 39-99) underwent TKA at Regional Hospital Knee and Hip Institute. Retrospective chart review was done to identify patients’ characteristics that were associated with AKI after TKR. Logistic regression was used to evaluate AKI.Results:AKI occurred in 21.9% of patients. AKI risk decreased between 2008 and 2009 (odds ratio, 0.55; 95% CI, -0.37 to 0.82) but increased with age (P < 0.001), diabetes mellitus (DM), and angiotensin converting enzyme inhibitors (ACEI)/angiotensin receptor blockers (ARB) use (OR, -1.6; 95% CI, -1.0 to 2.5; and OR, -1.5, 95% CI, -1.0 to 2.3, respectively). However, the effects of DM and ACEI/ARB use were not independent; when both were included in the regression model, neither was statistically significant, and both ORs were smaller than combined OR.Conclusions:When examined separately, both DM and preoperative ACEI/ARB use increased the risk of AKI; however these factors were correlated and were not independent predictors of significantly increased risk. Patients with DM have higher tendency to develop AKI and hence, preoperative renal risk stratification should be done in all patients with DM.

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Section: Discussionmentioning

confidence: 99%

Predictors of Acute Kidney Injury in Geriatric Patients Undergoing Total Knee Replacement Surgery

Sehgal¹,

Bajwa²,

Sehgal³

et al. 2014

Int J Endocrinol Metab

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“…The experience-based empirical anesthesia practice should always consider evidence-based approach in such clinical situations. [23] The best clinical pearl in such situation is to believe and treat immediately what is happening in front of you. Disbelief and insecurity are common patterns of this situation and may influence the final outcome.…”

Section: Discussionmentioning

confidence: 99%

Unanticipated cardiac arrest under spinal anesthesia: An unavoidable mystery with review of current literature

Kumari

Bajwa²,

Singh³

2014

Anesth Essays Res

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Cardiac arrest during anesthesia and perioperative period is a matter of grave concern for any anesthesiologist. But such mishaps have been reported for one reason or the other in the literary sciences. We are reporting the occurrence of unanticipated delayed cardiac arrest following spinal anesthesia in two young and healthy patients. Fortunately, these patients were successfully resuscitated with timely and appropriate cardiopulmonary resuscitative measures. Occurrence of such cases needs timely reporting and exploring all the possible causes of these unusual and possibly avoidable events. The present case reports are an important addition to a series of recently published mishaps that occurred during spinal anesthesia in young and healthy patients.

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“…Only those interventions which are ethically acceptable, that is, backed by evidence, or by expert consensus, should be practiced. [7] There often exists a state of equipoise in anesthesia, when there is no definite opinion in favor of, or agonist, a variety of treatments available for a particular clinical situation. An example would be choosing between general anesthesia and neuraxial anesthesia for an upper abdominal surgery.…”

mentioning

confidence: 99%

“…Similar instances can be cited where one keeps on performing neuraxial or epidural punctures in case of a difficult regional anesthesia in spite of repeated failures just as if to regain some “regional glory.” The concept of logical empiricism holds good here and is definitely an important component of quaternary prevention. [7] As a matter of fact, quaternary prevention, for example, does not allow one to order serum electrolytes at four hourly intervals and plasma glucose estimations at hourly gaps, unless it is critically indicated or at least there is a competent and specialist healthcare provider trained to act upon those values. The resources are scarce in developing nations and care should be taken by every physician including anesthesiologist to optimally utilize them for care of operative and critically ill patients.…”

mentioning

confidence: 99%

Quaternary prevention in anesthesiology: Enhancing the socio-clinical standards

Bajwa

Kalra

Takrouri³

2014

Anesth Essays Res

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Failed ventilation due to heat and moisture exchange filter malfunction: A difficult diagnostic scenario

Cited by 12 publications

References 8 publications

Predictors of Acute Kidney Injury in Geriatric Patients Undergoing Total Knee Replacement Surgery

Predictors of Acute Kidney Injury in Geriatric Patients Undergoing Total Knee Replacement Surgery

Unanticipated cardiac arrest under spinal anesthesia: An unavoidable mystery with review of current literature

Quaternary prevention in anesthesiology: Enhancing the socio-clinical standards

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