ABSTRACT
OBJECTIVE: To evaluate the efficacy of apneic oxygenation for the performance of pan-endoscopy. STUDY DESIGN: Clinical retrospective study. SETTING: A university teaching hospital in Wuppertal, Germany. SUBJECTS: Forty-seven patients who underwent pan-endoscopy under apneic oxygenation during a period of 1 year. METHODS: After preoxygenation and induction of anesthesia, an 8 French catheter was introduced into the trachea for oxygen supply. Pan-endoscopy was carried out, as long as there were no signs of desaturation. The data were collected retrospectively from the anesthesia charts. RESULTS: Apnea was well tolerated up to 45 minutes in most of the patients. In 2 patients, the method was carried out incorrectly, and in 1 obese patient, it was not possible to get an acceptable oxygenation. CONCLUSION: With appropriate monitoring, sufficient nitrogen elution, and proper patient selection, we believe that this technique is superior to jet ventilation and intubation for pan-endoscopy, allowing unimpeded operative visualization.
Subject(s)
Anesthesia/methods , Apnea/physiopathology , Endoscopy/methods , Intubation, Intratracheal/methods , Oxygen Inhalation Therapy/methods , Oxygen/administration & dosage , Respiration, Artificial/methods , Adult , Aged , Electrocardiography , Female , Follow-Up Studies , Humans , Male , Middle Aged , Partial Pressure , Retrospective StudiesABSTRACT
We report on a patient with acute intermittent porphyria, who received 8 AB0 incompatible units of packed red blood cells in an emergency situation. She never showed any signs of severe intravascular haemolysis. The patient died after four weeks because of a multi-organ failure caused from the malpractice of the porphyria. The problems of bedside testing, mixing field reaction, fresh frozen plasma and molecular-genetic determination of bloodgroup were discussed.