Intraoperative Ventilatory Pressures During Robotic Assisted vs Open Radical Cystectomy.

Objective: To investigate whether Robotic assisted radical cystectomy (RARC) is associated with increased postoperative pulmonary complications compared to open radical cystectomy (ORC). RARC poses challenges for ventilation with positioning and abdominal insufflation. Conventionally protective mechanical ventilation may be challenging, especially in patients with obesity or pulmonary comorbidities.

Phenytoin Pharmacokinetics During Venoarterial Extracorporeal Membrane Oxygenation and Plasma Exchange.

Currently, there is minimal guidance to antiepileptic dose adjustment for a patient requiring either venoarterial (VA) extracorporeal membrane oxygenation (ECMO) or plasma exchange (PLEX) therapy, and to our knowledge, there are rare guidances for a patient requiring both. Given the dangers with non-therapeutic concentrations of phenytoin, it is critical for the intensive care unit (ICU) practitioner to understand how the pharmacokinetic parameters of phenytoin change in critically ill patients requiring extracorporeal support. This case study presents a 41-year-old female transferred to the cardiovascular ICU requiring VA ECMO and PLEX for the treatment of systemic lupus erythematosus (SLE)-induced catastrophic antiphospholipid syndrome (CAPS).