From the Editor
Case Reports in the May issues teach us that things may not be as they appear.
The May 1 issue presents a case in which Tone and colleagues describe hematomas in a patient’s airway, compromising the ability to handle oral secretions and potentially progressing to acute airway narrowing. What does not intuitively appear is the unusual factor XIII coagulopathy that caused the spontaneously occurring hematomas. The case report describes the airway management and along with Editorial Comment from Wolberg and Levy catalogues the details of factor XIII deficiency.
In the May 15 issue, Kariya and colleagues describe a patient whose liver transplant surgically-induced anemia was extremely profound. Hong and colleagues present the acute hemodilution experienced by a Jehovah’s Witness patient undergoing coronary artery bypass surgery. What does not intuitively appear and is well detailed in both cases and Editorial comment from Spiess is that maintaining circulating vascular volume, even when red cell mass is markedly depleted, avoiding vasopressors and relying on dissolved rather than red cell bound oxygen are key factors in maintaining cellular integrity and aerobic metabolism.
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