Juniper Publishers Journal of Anesthesia and Intensive Care Medicine

Juniper Publishers - Open Access Journals Idiopathic Hyperammonemia after Orthotopic Lung Transplantation Authored by Tyson Kathleen Idiopathic hyperammonemia is characterized by increased serum ammonia levels (>200umol/L) and is sometimes associated with normal to slightly elevated liver function tests [1]. These patients often present with encephalopathy, cerebral edema, seizures, and coma. Idiopathic hyperammonemia has been reported after high dose chemotherapy, and organ transplants including Orthotopic lung transplant [2]. Hyperammonemia is a rare, severe, and often fatal complication. There are few cases reported in the literature since 1997, including one retrospective analysis of 807 lung transplants; only 8 patients were diagnosed with hyperammonemia [3]. The exact mechanism of idiopathic hyperammonemiais not fully understood with congenital or acquired defects in ammonia metabolism, as well as bacterial infection having been described [3]. F

Juniper Publishers - Open Access Journals Multimodal Anesthesia for Glaucoma Surgery in a Child with Mitochondrial Disease and Malignant Hyperthermia Authored by Benjamin Pruden Mitochondrial diseases (MD) are characterized by impairments of mitochondrial function that precipitate metabolic acidosis. An 8-year-old MD female with prior anesthesia exposure complicated by metabolic acidosis, seizures and propofol infusion syndrome, presented for glaucoma surgery. We present a multimodal balanced anesthetic technique used to successfully manage this complex case. Mitochondrial disorders (MD) are a heterogeneous group of genetic disorders that impair mitochondrial integrity and result in deficient energy production. The disorder has an incidence of 1:5000 live births [1], and affects tissues with high-energy requirements such as the central nervous system, retina, heart and muscle [2]. Consequently, these patients have multiple co-morbidities that include cardiac