Association of anesthesia type with prolonged postoperative intubation in neonates undergoing inguinal hernia repair.

PURPOSE: The purpose of this study is to determine factors associated with prolonged intubation after inguinal herniorrhaphy in neonates. METHODS: Retrospective, single institution review of neonates undergoing inguinal herniorrhaphy between 2010 and 2018. Variables recorded included demographics, comorbidities, ventilation status at time of hernia repair, and anesthetic technique. RESULTS: We identified 97 neonates (median corrected gestational age 39.9 weeks, IQR 6.6). The majority (87.6%) received general anesthesia (GA); the remainder received caudal anesthesia (CA). Among the GA subjects, 25.8% remained intubated for at least 6 h after surgery, whereas none of the CA patients required intubation postoperatively (p = 0.03). Two risk factors associated with prolonged postoperative intubation: a history of intubation before surgery (p = 0.04) and a diagnosis of bronchopulmonary dysplasia (p = 0.03). CONCLUSIONS: Neonates undergoing inguinal herniorrhaphy under GA have a greater rate of prolonged postoperative intubation compared with those undergoing CA. A history of previous intubation and bronchopulmonary dysplasia were significant risk factors for prolonged postoperative intubation.

Trans-Catheter Aspiration of Systemic Air Embolism Causing Cardiac Compromise During CT-Guided Lung Biopsy, a Potentially Lifesaving Maneuver.

Systemic artery embolism is a rare complication of CT-guided lung biopsy. Immediate clinical and radiological recognitions are crucial for rapid intervention and prevention of fatal outcome. Although hyperbaric oxygen is the suggested treatment of mildly symptomatic systemic artery embolization, aspiration of air should be considered as part of the management in cases of cardiac arrest.