Netherlands Journal of Critical Care Is Indexed In: Abstracts Dutch Annual Intensive Care Meeting 2013 Evidence
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Lung Transplantation As Therapeutic Option in Acute Respiratory Distress Syndrome for Coronavirus Disease 2019-Related Pulmonary fibrosis
Original Article Lung transplantation as therapeutic option in acute respiratory distress syndrome for coronavirus disease 2019-related pulmonary fibrosis Jing-Yu Chen1, Kun Qiao2, Feng Liu1,BoWu1, Xin Xu3, Guo-Qing Jiao4, Rong-Guo Lu1, Hui-Xing Li1, Jin Zhao1, Jian Huang1, Yi Yang5, Xiao-Jie Lu6, Jia-Shu Li7, Shu-Yun Jiang8, Da-Peng Wang8, Chun-Xiao Hu9, Gui-Long Wang9, Dong-Xiao Huang9, Guo-Hui Jiao1, Dong Wei1, Shu-Gao Ye1, Jian-An Huang10, Li Zhou1, Xiao-Qin Zhang1, Jian-Xing He3 1Wuxi Lung Transplant Center, Wuxi People’s Hospital Affiliated to Nanjing Medical University, Wuxi, Jiangsu 214023, China; 2Department of Thoracic Surgery, Shenzhen Third People’s Hospital, Shenzhen, Guangdong 518100, China; 3Department of Thoracic Surgery/Oncology, State Key Laboratory and National Clinical Research Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510120, China; 4Department of Cardiothoracic Surgery, Wuxi People’s Hospital Affiliated to Nanjing Medical University, Wuxi, Jiangsu 214023, China; 5Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu 210009, China; 6Wuxi Fifth Hospital, Wuxi, Jiangsu 214000, China; 7Department of Respiratory Medicine and Critical Care Medicine, The First People’s Hospital of Lianyungang City, Lianyungang, Jiangsu 222061, China; 8Department of Critical Care Medicine, Wuxi People’s Hospital Affiliated to Nanjing Medical University, Wuxi, Jiangsu 214023, China; 9Department of Anesthesiology, Wuxi People’s Hospital Affiliated to Nanjing Medical University, Wuxi, Jiangsu 214023, China; 10Department of Respiratory Medicine, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, China. Abstract Background: Critical patients with the coronavirus disease 2019 (COVID-19), even those whose nucleic acid test results had turned negative and those receiving maximal medical support, have been noted to progress to irreversible fatal respiratory failure. -
1 SUPPLEMENTAL MATERIAL Use of Non-Indicated Cardiac
SUPPLEMENTAL MATERIAL Use of Non-Indicated Cardiac Testing in Low-Risk Patients: Choosing Wisely METHODS SUPPLEMENT Data Source and Study Population Using the Medicare 40% denominator file, we identified all fee-for-service Medicare beneficiaries enrolled in Medicare Parts A, B, and D (inpatient, outpatient and prescription coverage), 2006-2011, and created six annual enrollment cohorts. We excluded beneficiaries with a gap of one or more months in fee-for-service Medicare Parts A, B, or D enrollment during a calendar year. We limited our analysis to beneficiaries aged 66-80. Beneficiary characteristics, including age, sex, race/ethnicity (black, Hispanic, other), and Medicaid enrollment, were obtained from the Medicare denominator file. Residential ZIP Codes were used to assign each beneficiary to one of 306 Dartmouth Atlas of Health Care hospital referral regions (HRRs). Information on regional physician workforce in 2006 was obtained from the Dartmouth Atlas of Health Care. Defining Low- and High-Risk Cohorts To identify annual cohorts of low-risk patients, each beneficiary was annually assigned a cardiovascular disease risk status (low or high) based on records in Medicare Carrier, Outpatient, MedPAR, Hospice and Prescription Drug Event files. For each annual enrollment cohort, beneficiaries with no evidence of significant cardiovascular disease or cardiovascular disease risk were deemed low-risk and those with such conditions were deemed high-risk. Using Hierarchical Condition Category International Classification of Disease, Ninth Revision, code lists, the following diagnoses (appearing in two physician claims or one hospital claim) were considered evidence of high cardiovascular disease risk: HIV/AIDS, diabetes, drug or alcohol abuse/dependence, shock, cardiac disease (e.g. -
A Case of Thoracic Aortic Injury Caused by Multiple Rib Fractures
3 Case Report Page 1 of 3 A case of thoracic aortic injury caused by multiple rib fractures Weigang Zhao#, Weiwei He#, Yi Yang, Yonghong Zhao Department of Thoracic Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China #These authors contributed equally to this work. Correspondence to: Yonghong Zhao. Department of Thoracic Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, 600 Yishanlu Road, Shanghai 200233, China. Email: [email protected]. Abstract: Thoracic aortic injury is fatal but rare in blunt chest trauma, which usually requires urgent surgical treatment. It is mostly caused by posterior rib fractures. Chest wall stabilization (CWS) has been widely performed in patients with multiple rib fractures all over the world in the past two decades with satisfactory outcomes. However, the surgical treatment of posterior rib fracture within 2–3 cm from transverse process is still a difficult problem for thoracic surgeons. Under this circumstance, rib-transverse process internal fixation method was developed and widely performed for above patients at present. In this article, we presented a case of thoracic aortic injury caused by multiple rib fractures. A 54-year-old female was admitted to our hospital with dyspnea and severe chest pain caused by a falling object. Thoracic aortic injury with multiple rib fractures were diagnosed basing on image date and emergency CWS was performed for this patient. Rib-transverse process internal fixation was not performed in this case since the patients combined with transverse process fracture. We firstly performed transverse process resection combined with CWS for this patient. The results of our study showed this method is safe and feasible for patients with multiple rib fractures combined with transverse process fracture. -
Vertical Perspective Medical Assistance Program
Kansas Vertical Perspective Medical Assistance Program December 2006 Provider Bulletin Number 688 General Providers Emergent and Nonemergent Diagnosis Code List Attached is a list of diagnosis codes and whether the Kansas Medical Assistance Program (KMAP) considers the code to be emergent or nonemergent. Providers are responsible for validating whether a particular diagnosis code is covered by KMAP under the beneficiary’s benefit plan and that all program requirements are met. This list does not imply or guarantee payment for listed diagnosis codes. Information about the Kansas Medical Assistance Program as well as provider manuals and other publications are on the KMAP Web site at https://www.kmap-state-ks.us. If you have any questions, please contact the KMAP Customer Service Center at 1-800-933-6593 (in-state providers) or (785) 274-5990 between 7:30 a.m. and 5:30 p.m., Monday through Friday. EDS is the fiscal agent and administrator of the Kansas Medical Assistance Program for the Kansas Health Policy Authority. Page 1 of 347 Emergency Indicators as noted by KMAP: N – Never considered emergent S – Sometimes considered emergent (through supporting medical documentation) Y – Always considered emergent Diagnosis Emergency Diagnosis Code Description Code Indicator 0010 Cholera due to Vibrio Cholerae S 0011 Cholera due to Vibrio Cholerae El Tor S 0019 Unspecified Cholera S 019 Late Effects of Tuberculosis N 0020 Typhoid Fever S 0021 Paratyphoid Fever A S 0022 Paratyphoid Fever B S 0023 Paratyphoid Fever C S 024 Glanders Y 025 Melioidosis -
Künt Toraks Travmasi
Müracaat Tarihi / Application Date: 08.09.2017 DERLEME / REWIEV Kabul Tarihi / Acceptance Date: 03.10.2017 KÜNT TORAKS TRAVMASI BLUNT THORACIC TRAUMA Ahmet Gökhan Öz Travma 40 yaş altında görülen ölümlerin en sık nedenidir. Vakaların Gündoğdu*, hemen hemen dörtte biri toraks travmasıdır ve bunların da önemli bir Hasan Ekrem Çamaş*, yüzdesini künt travmalar oluşturur. Yaralanma izgesi minör Rasih Yazkan*. vakalardan ciddi, hayatı tehdit edenlere kadar çeşitlilik gösterebilir. Künt toraks travması hakkında yeterli bilgi sahibi olunması ve travmanın meydana geldiği yerde başlayan uygun bakım, morbidite ve mortalitenin azaltılmasında son derece önemlidir. Anahtar Kelimeler: künt, toraks, travma Abstract: Trauma is the most common cause of death under 40 years of age. Almost a quarter of these cases are thoracic trauma, in which blunt *: Süleyman Demirel ones constitute a major percentage. The spectrum of the injuries may University, Faculty of vary from minor ones to severe lifethreatening cases. Adequate Medicine, Department of knowledge on blunt thoracic trauma and proper care starting at the Thoracic Surgery site of the impact are crucial for decreasing morbidity and mortality rates. Keywords: blunt, thorax, trauma Yazışma Adresi: Ahmet Gökhan Gündoğdu Süleyman Demirel University, Faculty of Medicine, Department of Thoracic Surgery Çünür Mah. 32246 Isparta/ TURKEY gokhangundogdu@hotmail. com 533/2506281 86 Med J SDU / SDÜ Tıp Fak Derg 2018:25(1):86-97 DOI : 10.17343/sdutfd.337201 Gündoğdu ve ark. BLUNT THORACIC TRAUMA the first 2 ribs suggests a high energy trauma Adequate knowledge about thoracic trauma and and damage to the subclavian vessels and associated injuries is crucial for proper brachial plexus may accompany the situation. -
Key to Respiratory Pathology Aperio Histology Cases - Diagnoses
Key to respiratory pathology Aperio histology cases - Diagnoses Title Species Diagnosis Case number Case details 03-33330A cytokeratin Bovine Cytokeratin-normal lung 03-33330B cytokeratin Bovine Cytokeratin-normal lung 07-107482-A1 Porcine Swine influenza Swine influenza--with nice IHC. 38514-98 Wild boar Metastrongylus 98-38514-5 Feedlot steer, bronchiolitis obliterans, as a sequel to viral bronchiolar necrosis, with arteriolar hypertrophy and 97-3591 Bovine Bronchiolitis fibrosa obliterans heart failure 98-887-20A 20hrs pi 20 hours after Mannheimia challenge 98-887-20B 20hrs pi 20 hours after Mannheimia challenge 98-887-3A 3hrs pi 3 hours after Mannheimia challenge 98-887 Lambs with low antibody titres, challenged by aerosol with PI3V then 6 x 10^8 cfu of M. haemolytica. 98-887-3B 3hrs pi 3 hours after Mannheimia challenge 98-887-8A 8hrs pi 8 hours after Mannheimia challenge 98-887-8B 8hrs pi 8 hours after Mannheimia challenge ACVP-81 Equine Silicosis Slide from an old ACVP meeting. Gross postmortem examination reveals multifocal, well-demarcated, pale, bulging, solid regions within all lung lobes (from <1 to 4cm dia). Contained airways exude frothy fluid although only small amounts of such fluid is noted in the mainstem bronchi or trachea. Histopathological examination of affected lung reveals multifocal, unencapsulated regions where the alveolar architecture is obscured by complex acinar & papillary arrangements of well regimented columnar cells on thin fibrovascular septi. These cells are densely packed, have pale eosinophilic to clear cytoplasm & basally orientated vesicular nuclei. Mitotic figures are inconspicuous. Infiltrates of neutrophils & macrophages are noted within contained & adjacent airspaces. -
Endovascular Stent in Traumatic Thoracic Aortic Dissection
Case Report http://dx.doi.org/10.4070/kcj.2012.42.5.341 Print ISSN 1738-5520 • On-line ISSN 1738-5555 Korean Circulation Journal Endovascular Stent in Traumatic Thoracic Aortic Dissection Mi Ok Jang, MD, Ju Han Kim, MD, Sang Ki Oh, MD, Min Goo Lee, MD, Keun Ho Park, MD, Doo Sun Sim, MD, Young Joon Hong, MD, Youngkeun Ahn, MD, and Myung Ho Jeong, MD The Heart Center of Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea Traumatic thoracic aortic injury is typically fatal. However, recent improvements in pre-hospital care and diagnostic modalities have re- sulted in an increased number of patients with traumatic aortic injury arriving alive at the hospital. Also, the morbidity and mortality as- sociated with endovascular repair are significantly lower than with conventional open surgery in traumatic thoracic aorta injury. We expe- rienced two cases of successful management of traumatic thoracic aortic dissection with endovascular stents caused by traffic accidents. (Korean Circ J 2012;42:341-344) KEY WORDS: Aorta, thoracic; Dissection; Aortography; Multidetector computed tomography. Introduction Cases Patients with blunt traumatic thoracic aorta injuries are increas- Case 1 ingly admitted to hospital due to the increasing number of traffic A 28-year-old male suffered from a traffic accident while in a car. accidents per day. Traumatic thoracic aortic injury is typically fatal. His mental status was confused but brain CT revealed non-specific The thoracic aorta wall ruptures after blunt thorax trauma and if not findings. He had no known history of hypertension, diabetes, hep- treated, has very poor outcome with an initial survival rate ranging atitis, and pulmonary tuberculosis. -
Traumatic Diaphragmatic Hernia: 28-Years Analysis at a Brazilian University Hospital
Traumatic diaphragmatic hernia: 28-years analysis at a Brazilian university hospital Vitor Kruger ( [email protected] ) State University of Campinas Thiago Calderan State University of Campinas Rodrigo Carvalho State University of Campinas Elcio Hirano State University of Campinas Gustavo Fraga State University of Campinas Research Article Keywords: Traumatic diaphragmatic hernia, diaphragm, hernia, diaphragmatic injury Posted Date: December 17th, 2020 DOI: https://doi.org/10.21203/rs.3.rs-121284/v1 License: This work is licensed under a Creative Commons Attribution 4.0 International License. Read Full License Page 1/16 Abstract Background The objective of the study is evaluate the approach to patients with acute traumatic diaphragmatic hernia at a Brazilian university hospital during a 28-year period. Traumatic diaphragmatic hernia is an uncommon injury, however its real incidence may be higher than expected. Sometimes is missed in trauma patients, and is usually associated with signicant morbidity and mortality, this analysis may improve outcomes for the trauma patient care. Methods Retrospective study of time series using and analisys database records of trauma patients at HC- Unicamp was performed to investigate the incidence, trauma mechanism, diagnosis, herniated organs, associated injuries, trauma score, morbidity, and mortality of this injury. Results Fifty-ve cases were analyzed. Blunt trauma was two-fold frequent than penetrating trauma, are associated with high grade injury and motor vehicle collision was the most common mechanism. Left side hernia was four-fold frequent than right side. Diagnose was mostly performed by chest radiography (31 cases; 56%). Associated intra-abdominal injuries were found in 37 patients (67.3%) and extra- abdominal injuries in 35 cases (63.6%). -
Investigation of the Traumatic Rupture of the Aorta (Tra) by Simulating Real-World Accidents
INVESTIGATION OF THE TRAUMATIC RUPTURE OF THE AORTA (TRA) BY SIMULATING REAL-WORLD ACCIDENTS Chirag S. Shah, Warren N. Hardy, King H. Yang Bioengineering Center, Wayne State University, Detroit, MI, USA Chris A. Van Ee Design Research Engineering, Novi, MI, USA Richard M. Morgan and Kennerly H. Digges The George Washington University, Ashburn, VA, USA ABSTRACT Traumatic rupture of the aorta (TRA) is one of the causes of death in automotive crashes. The risk of fatality is higher if the injury is not detected and treated promptly. Numerous laboratory experiments, retrospective studies, and theories with focus on TRA have yielded limited success. Four real-world accidents with aortic injuries to the occupants were simulated using finite element (FE) methods. Two crashes were side impact, and the other two were frontal crashes. A two-phase approach was used. For Phase 1, car-to-car interaction was simulated using vehicle FE models. These simulations were validated qualitatively and quantitatively against available crash photographs and crush data. For Phase 2, interaction between the occupant and the interior of the automobile was simulated using input obtained as a result of the first phase simulation. The occupant was a mid-sized male whole-body human FE model developed at Wayne State University. For the two side impact crashes, the peri-isthmic region demonstrated the greatest maximum principal strain (MPS) and longitudinal stress (LS). For the frontal crashes, the junction of the ascending aorta and the aortic arch was the region of greatest MPS and LS. Peak MPS and peak LS averaged within the peri-isthmic region of the aorta for the second phase FE simulations ranged from 0.072 to 0.160, and 0.93 MPa to 1.58 MPa, respectively. -
Survival After Intrapericardial IVC Rupture and Traumatic Aortic Transection
Injury Extra 43 (2012) 134–136 Contents lists available at SciVerse ScienceDirect Injury Extra jou rnal homepage: www.elsevier.com/locate/inext Case Report Survival after intrapericardial IVC rupture and traumatic aortic transection a, b b c d a J.W. Duijff *, F. Meikle , A. El-Gamel , C. Holdaway , M. Swarbrick , G.R. Christey a Department of Trauma and General Surgery, Waikato Hospital, Hamilton, New Zealand b Department of Cardiothoracic Surgery, Waikato Hospital, Hamilton, New Zealand c Department of Vascular Surgery, Waikato Hospital, Hamilton, New Zealand d Department of Radiology, Waikato Hospital, Hamilton, New Zealand A R T I C L E I N F O speed. He was thrown approximately 6 m from his bike. On Article history: arrival, he had a blood pressure of 97/62 mmHg and heart rate of À1 Accepted 5 July 2012 97 min . Shortly after, his blood pressure dropped to 40/ 20 mmHg. Chest X-ray showed a large haemothorax on the right (Fig. 1) for which a chest tube was placed. This drained 1500 ml immediately but then stopped draining. He was intubated. Because of persistent haemodynamic instability the massive transfusion protocol (containing red blood cells, fresh frozen 1. Introduction plasma and platelets in a 1-1-1 ratio) was activated. He received 1 g of Tranexamic acid twice while in the ED. The FAST scan was Trauma to the great vessels in the chest is life-threatening normal and the abdomen soft and non-distended. A second chest [4,11]. These injuries are usually caused by blunt trauma with a X-ray revealed a large mediastinal haematoma as well as a large significant deceleration force [11], but can also arise from haemothorax on the left (Fig. -
Spontaneous Pulmonary Hematoma with No Underlying Causes: a Case Report
http://dx.doi.org/10.4046/trd.2015.78.4.363 CASE REPORT ISSN: 1738-3536(Print)/2005-6184(Online) • Tuberc Respir Dis 2015;78:363-365 Spontaneous Pulmonary Hematoma with No Underlying Causes: A Case Report Eun Joo Lee, M.D.1, Sang Hoon Park, M.D.1, Ho Hyun Park, M.D.1, Seung Heon Park, M.D.1, Jung Yeon Lee, M.D.2, Woo Surng Lee, M.D., Ph.D.3 and Sun-Young Yoon, M.D., Ph.D.4 1Department of Internal Medicine, 2Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, 3Department of Thoracic and Cardiovascular Surgery, 4Division of Allergy and Pulmonology, Department of Internal Medicine, Konkuk University Chungju Hospital, Chungju, Korea A 57-year-old male patient was admitted to our center because of a cystic mass on the lower portion of the right major fissure that was found incidentally by chest X-ray. He did not have a history of trauma or anticoagulant use. The lesion was removed by video-assisted thoracoscopic surgery. Pathological examination revealed an organizing pulmonary hematoma without any complications, and a follow-up chest X-ray after 1 year showed no recurrence. Keyword: Hematoma Introduction subclavian vein catheterization3,4. One study reported a total of 38 cases of pulmonary hematoma, and all of these cases Pulmonary hematomas are collections of blood within the occurred after thoracic injury5. To the best of our knowledge, alveolar and interstitial spaces1. Usually, they are resolved no case of pulmonary hematoma has manifested without within two to four weeks. However, if secondary infection any underlying causes. -
Review of Cardiothoracic Surgery
TSRA Review of Cardiothoracic Surgery Carlos M. Mery Joseph W. Turek TSRA Review of Cardiothoracic Surgery Edited by: Carlos M. Mery, MD, MPH Cardiothoracic surgery fellow University of Virginia Charlottesville, VA President TSRA 2010 – 2011 Joseph W. Turek, MD, PhD Congenital cardiac surgery fellow Children’s Hospital of Philadelphia Philadelphia, PA President TSRA 2009 – 2010 Thoracic Surgery Residents Association www.tsranet.org TSRA Review of Cardiothoracic Surgery Copyright © 2011 by the Thoracic Surgery Residents Association, Carlos M. Mery, Joseph W. Turek TSRA / TSDA 633 N. Saint Clair Street Suite 2320 Chicago, IL 60611 www.tsranet.org Disclaimer The material presented herein is, to the best of our knowledge, accurate and factual to date. The information is provided as a basic guideline for the study of cardiothoracic surgery and should be used in conjunction with a variety of other educational references and resources. The TSRA Re- view of Cardiothoracic Surgery should not be construed as a definitive study guide for either the TSDA In-Training Exam or the ABTS Certification Exam. TSRA makes no claims regarding the study guide's value in preparing for, or its contribution toward performance on, either the TSDA In-Training Exam or the ABTS Certification Exam. All rights reserved. This book is protected by copyright. No part of this book may be reproduced in any form or by any means, electronic or mechanical, including photocopying or the use of any information storage and retrieval system without written permission from the copyright owners. Cover artwork by: Carmina Mery, Ramón Mery, and Mari Pili Guzmán (age 3) To all cardiothoracic surgery residents, present and future.