Michael G Fitzsimons

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Traumatic pulmonary herniation involves the protrusion of lung parenchyma beyond the normal borders of the thoracic cage through a defect in the musculoskeletal wall. Anesthetic management involves airway protection, lung isolation, and avoidance of distension of the herniated segment. We report the successful anesthetic management during surgical(More)
Substance abuse occurs in approximately 1%-2% of anesthesia residents and nearly 80% of programs have had one or more resident (s) with such a problem. Education and control efforts have failed to reduce the frequency of substance abuse. Anesthesia providers have a professional obligation to be drug-free for the well being of their patients. We have(More)
A 39-year-old man developed significant methemoglobinemia after receiving benzocaine spray; he was treated appropriately with intravenous methylene blue. The patient's methemoglobin levels decreased, but this was followed by a critical rebound phenomenon to levels frequently considered near fatal. After further treatment with methylene blue, the patient's(More)
From the Department of Obstetrics and Gynecology (J.L.E.), the Divisions of Obstetrical Anesthesia (K.S.) and Cardiac Anesthesia (M.G.F.), Department of Anesthesia, Critical Care, and Pain Medicine, and the Department of Surgery (T.E.M.), Massachusetts General Hospital; and the Departments of Obstetrics, Gynecology, and Reproductive Biology (J.L.E.),(More)
A 35-year-old woman at 13 weeks gestation presented with adenoid cystic carcinoma of the distal left mainstem bronchus with chronic collapse of the left lung requiring carinal pneumonectomy. The extent of the tumor and need for significant retraction during dissection and pneumonectomy resulted in the need for cardiopulmonary bypass. The patient underwent(More)
Immunoglobulin A (IgA) deficiency may result in the development of anti-IgA antibodies. Such antibodies may result in anaphylaxis when patients receive standard blood products. Hemophilia A is a deficiency of clotting factor VIII that results in a significant coagulopathy and bleeding in the perioperative period unless precautions are taken. We present a(More)