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Case Report. Non-Obvious, Post-Traumatic, Life-Threatening Bleeding in Two Elderly Patients

College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012;141:e152S-e184S. doi: 10.1378/chest.11-2295. 3. Garcia D, Crowther MA, Ageno W. Practical management of coagulopathy associated with warfarin. BMJ. 2010;340:c1813. doi: 10.1136/bmj.c1813. 4. Ufer M. Comparative Pharmacokinetics of Vitamin K Antagonists: warfarin, phenprocoumon and acenocoumarol. Clin Pharmacokinet. 2005;44:1227-46. doi: 10.2165/00003088-200544120-00003 5. Villena Garrido V, Cases Viedma E, Fernandez Villar A, et al

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Residual curarization and postoperative respiratory complications following laparoscopic sleeve gastrectomy. The effect of reversal agents: sugammadex vs. neostigmine

;108:236-9. 9. Hayes AH, Mirakhur RK, Breslin DS, Reid JE, McCourt KC:Postoperative residual block after intermediate-acting neuromuscular blocking drugs. Anaesthesia 2001;56:213-8. 10. McDonagh DL, Benedict PE, Kovac AL, Drover DR, Brister NW, Morte JB, Monk TG. Efficacy, safety, and pharmacokinetics of sugammadex for the reversal of rocuronium-induced neuromuscular blockade in elderly patients. Anesthesiology. 2011;114:318-29. 11. Magnusson L, Spahn DR. New concepts of atelectasis during general anaesthesia. Br J Anaesth 2003;9:61-72. Anesth

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Anti-platelet Therapy Resistance – Concept, Mechanisms and Platelet Function Tests in Intensive Care Facilities

in the bioactivation of clopidogrel to its pharmacologically active metabolite. Drug Metab Dispos. 2010;38:92-9. 49. Kim KA, Park PW, Hong SJ, Park J-Y. The effect of CYP2C19 polymorphism on the pharmacokinetics and pharmacodynamics of clopidogrel: a possible mechanism for clopidogrel resistance. Clin Pharmacol Ther. 2008;84:236-42. 50. Mega JL, Close SL, Wiviott SD, et al. Cytochrome P-450 Polymorphisms and Response to Clopidogrel. N Engl J Med. 2009;360:354-62. 51. Varenhorst C, James S, Erlinge D, et al. Genetic

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Review. Perioperative Management of Lactic Acidosis in End-Stage Liver Disease Patient

. Pharmacokinetics and pharmacodynamics of dichloroacetate in patients with cirrhosis. Clin Pharmacol Ther 1999;66:380-390. 55. Nahas GG1, Sutin KM, Fermon C, et al. Guidelines for the treatment of acidaemia with THAM. Drugs. 1998;55:191-224. 56. Hoste EA, Colpaert K, Vanholder RC, et al. Sodium bicarbonate versus THAM in ICU patients with mild metabolic acidosis. J Nephrol. 2005;18:303-307. 57. Kraut J A, Madias NE. Treatment of acute metabolic acidosis: a pathophysiologic approach Nat. Rev. Nephrol 2012

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Increased Susceptibility to Postoperative PCA Morphine-Induced Respiratory Depression in a Patient with an Undiagnosed Traumatic Porencephalic Cyst – A Case Report

neurosurgical consultation. The patient and the family disclosed that the patient had not had any prior cranial imaging since the initial traumatic event. Discussion It is not entirely clear if the increased susceptibility to postoperative low-dose PCA morphine-induced respiratory depression in the patient with a large undiagnosed post-traumatic porencephalic cyst was due to functional changes in the pharmacokinetics and pharmacodynamics related to the structural changes of the brain. A porencephalic cyst is a cavity in the cerebral hemisphere filled with

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