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Background: There are few data on the effects of anesthesia and cardiopulmonary bypass (CPB) on perioperative renal function in children with cyanotic congenital heart disease undergoing open heart surgery. This study aims to investigate the perioperative renal function in cyanotic versus acyanotic children undergoing sevoflurane anesthesia for open heart surgery. Methods: After receiving ethical committee approval, 12 acyanotic patients (preoperative oxygen saturation: SaO2 > 85%%) and 12 cyanotic children (SaO2 < 85%%) were included. Sevoflurane was administered at concentration levels of 2%% before CPB and 1-2%% during CPB after standard anesthesia induction. Inorganic fluoride, electrolytes, creatinine, urea nitrogen in serum and urine samples, and N-acetyl-β- d-glucosaminidase (NAG) in urine samples were measured before induction, before CPB, during CPB, after CPB, at the end of surgery, and at 24th h postoperatively. Results: The levels of serum uric acid levels were higher in the cyanotic group ( p < 0.05). There were no differences in the levels of serum creatinine and urine creatinine, urea nitrogen, and electrolytes between the two groups. Serum inorganic fluoride levels were always higher in the acyanotic group than in the cyanotic group, but these differences between the groups reached statistical significance at two measurement times (before CPB and end of surgery) ( p < 0.05). Urinary inorganic fluoride levels increased with time in both groups. Although urinary NAG increased significantly after the CPB in the cyanotic group, the differences between the two groups did not reach statistical significance. Conclusions: We have concluded that renal function was not affected during open heart surgery with sevoflurane anesthesia, in both cyanotic and acyanotic children. [ABSTRACT FROM AUTHOR]

Electrical and pharmacologic stimulation of the efferent cholinergic antiinflammatory pathway suppress the systemic inflammatory response and can prevent lethal endotoxemia. Neostigmine, a cholinergic agent, has not been tested to determine if it can prevent histopathologic organ injury in endotoxemia. In the present study, the effects of neostigmine treatment on the histopathologic organ injury inflicted by Escherichia coli endotoxin in a mouse model of septic shock was investigated. Endotoxemia in mice caused weight loss and increased spleen, liver, and lung weight. When the organs were examined for histopathologic injury, endotoxemia increased interstitial inflammation in the lungs, liver injury, and organ injury in general terms; neostigmine, at a dose of 0.1 mg/kg, failed to attenuate these effects. Although the simultaneous administration of neostigmine at a dose of 0.3 mg/kg and endotoxin decreased interstitial inflammation in the lungs, vacuolar degeneration in the liver, and total liver injury, mortality was increased with this dose in the presence of endotoxemia. We conclude that neostigmine at a dose of 0.1 mg/kg was not protective against histopathologic organ injury in mice with endotoxemia, and a higher dose (0.3 mg/kg) was not tolerated probably owing to nonspecific parasympathetic action including cardiovascular effects. Further studies are required to determine the contribution of sites in the cholinergic antiinflammatory pathway. [ABSTRACT FROM AUTHOR]

Background and Aim: Laparoscopic hysterectomy (LH) have been frequently used because of low complication rates and short duration of hospital stay. Elevated intracranial pressure (ICP), a disadvantage of laparoscopic surgery, is caused by the Trendelenburg position (TP) and CO2 pneumoperitoneum (PP). This study aimed to evaluate TP and PP associated changes in ICP by ONSD measurements during LH. The intra‐and inter‐observer consistency and reliability of ONSD measurements were also investigated. Methods: Sixty patients with were enrolled into this prospective study. ONSD for each patient was measured by three anesthesiologists at T0, T1, T2, and T3 time points. ONSD, mean arterial pressure (MAP), end tidal CO2 (EtCO2), and arterial blood CO2 partial pressure values (PaCO2) were measured at T0: baseline, T1: 10 min after introducing 20 mmHg PP, T2: 10 min after placing the patient in TP and 15 mmHg PP and, T3: 10 min after PP deflation. Results: The ONSD measured at T1 (5.97 ± 0.49 cm) and T2 (5.95 ± 0.57 cm) were higher than T0 (5.63 ± 0.53 cm) and T3 (5.72 ± 0.47 cm) (p < 0.05). There were no correlations between MAP and ONSD, and also between PaCO2, EtCO2, and ONSD measurements at any time points. Inter‐observer intraclass correlation coefficient (ICC) values of ONSD measurements by all examiners had moderate (at T1) to good (at T0, T2, T3) reliability. Intra‐observer agreements were reasonable for each observer. Conclusion: ONSD measurements increase with CO2PP and TP in patients undergoing LH. Transorbital sonography is a reliable method to monitor intraoperative changes in ONSDs. This study underlines the need for careful training and the importance of standardization in order to obtain reliable results in the examination technique of ONSD measurements. [ABSTRACT FROM AUTHOR]

Here we report a patient who developed tumour lysis syndrome following a diagnostic tonsillectomy for suspected lymphoma. Following anesthesia induction, the patient suffered cardiopulmonary arrest, which required cardiopulmonary resuscitation. After successful resuscitation, the operation ended and the patient was transported to the intensive care unit. The patient's clinical course was diagnosed as tumor lysis syndrome due to documented clinical and laboratory parameters. This case report suggests that the development of tumour lysis syndrome is a consequence of several stressful conditions that are significantly associated with each other, and management should focus on prophylactic options, careful monitorization and treatment of clinical and laboratory abnormalities [ABSTRACT FROM AUTHOR]

Background: With an increase in the frequency of interventional radiology procedures in pediatrics, there has been a corresponding increase in demand for procedural sedation to facilitate them . The purpose of our study was to compare the frequency of adverse effects, sedation level, patient recovery characteristics in pediatric patients receiving intravenous propofol fentanyl combination with or without ketamine for interventional radiology procedures. Our main hypothesis was that the addition of ketamine would decrease propofol/fentanyl associated desaturation. Methods and materials: Sixty consenting American Society of Anesthesia physical status I–III pediatric patients undergoing interventional radiology procedures under sedation were studied according to a randomized, double-blinded, institutional review board approved protocol. Group 1 received propofol 0.5 mg·kg−1 + fentanyl 1 μg·kg−1 + ketamine 0.5 mg·kg−1, and group 2 received propofol 0.5 mg·kg−1 + fentanyl 1 μg·kg−1 + same volume of %0.9 NaCl intravenously. Results: While apnea was not observed in any of the groups, there were three cases (10%) in group 1, and nine cases (30%) in group 2 with oxygen desaturation ( P = 0.052). In group 1, 12 (40%) patients and, in group 2, 21 (70%) patients required supplemental propofol during the procedure ( P = 0.021). There was no evidence for difference between groups in terms of other side effects except nystagmus. Conclusions: In conclusion, addition of low dose ketamine to propofol-fentanyl combination decreased the risk of desaturation and it also decreased the need for supplemental propofol dosage in pediatric patients at interventional radiology procedures. [ABSTRACT FROM AUTHOR]

Balon valf sistemi entübe hastaların ventilasyonunda özellikle resusitasyon ve transportta sıkçakullanılan bir cihazdır. Bu cihazlar genellikle güvenlidir, ancak bunların önerilenkullanımlarındaki minör değişiklikler hastaları yüksek havayolu basınçlarına maruzbırakabilmektedir. Özellikle, yüksek akımlı ek oksijene bağlı oksijen rezervuarının gerilmesi,kaçak deliğinden akımın azalması, tıkanması veya bunların kombinasyonları balon valf sisteminiinspirasyonda kilitler, ekspirasyonu engeller ve böylece yüksek havayolu basınçlarına nedenolabilir. Bu olgu takdiminde, balon valf sistemiyle transport sırasında aniden gelişenpnömotoraks olgusunu sunmayı amaçladık. [ABSTRACT FROM AUTHOR]

Balon valf sistemi entübe hastaların ventilasyonunda özellikle resusitasyon ve transportta sıkçakullanılan bir cihazdır. Bu cihazlar genellikle güvenlidir, ancak bunların önerilenkullanımlarındaki minör değişiklikler hastaları yüksek havayolu basınçlarına maruzbırakabilmektedir. Özellikle, yüksek akımlı ek oksijene bağlı oksijen rezervuarının gerilmesi,kaçak deliğinden akımın azalması, tıkanması veya bunların kombinasyonları balon valf sisteminiinspirasyonda kilitler, ekspirasyonu engeller ve böylece yüksek havayolu basınçlarına nedenolabilir. Bu olgu takdiminde, balon valf sistemiyle transport sırasında aniden gelişenpnömotoraks olgusunu sunmayı amaçladık. [ABSTRACT FROM AUTHOR]