Journal of Anesthesia and Critical Care: Open access最新文献

{"title":"Optics “clear vision”, storozhynets, chernivtsi region, Ukraine","authors":"Oksana Dmytrivna Rudkovska","doi":"10.15406/jaccoa.2022.14.00510","DOIUrl":"https://doi.org/10.15406/jaccoa.2022.14.00510","url":null,"abstract":"Manifestation of ocular symptoms in severe covid patients reaches 30% - 60% of cases. This high frequency of involvement of the visual analyzer in the pathological process is explained as follows: the visual system is very energy consuming, and when the general condition of the body is severe, the brain blocks the visual analyzer (motor and / or sensory parts) to pay more attention to other vital organs and systems (paralysis of motor activity of the eye muscles or a significant drop in visual acuity saves brain resources). In severe Covid -19, it is proposed to switch the visual analyzer to \"energy saving mode\": turn off the pupillary response and accommodation (cycloplegics) and close the eyes with a bandage (for a while). These manipulations (artificial blocking of the visual analyzer) can improve the overall condition of the patient and reduce the risk of blindness.","PeriodicalId":228896,"journal":{"name":"Journal of Anesthesia and Critical Care: Open access","volume":"115 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127301550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical audit on patient hand over at NEMMH PACU","authors":"Mitiku Desalegn","doi":"10.15406/jaccoa.2022.14.00505","DOIUrl":"https://doi.org/10.15406/jaccoa.2022.14.00505","url":null,"abstract":"","PeriodicalId":228896,"journal":{"name":"Journal of Anesthesia and Critical Care: Open access","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131189006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"OHVIRA syndrome obstetric patient for lower segment caesarean section: peri-operative considerations","authors":"Amit Kumar, U. Hariharan, Rejitha Chandran, V. Nagpal","doi":"10.15406/jaccoa.2021.13.00496","DOIUrl":"https://doi.org/10.15406/jaccoa.2021.13.00496","url":null,"abstract":"OHVIRA syndrome is a rare congenital developmental condition manifested by uterus didelphys, lower genital tract obstruction and unilateral renal anomaly. We report a rare case of a full term obstetric patient with OHVIRA syndrome, posted for elective lower segment caesarean section. Peri-operative anaesthetic considerations in a patient with this syndrome have been described. The importances of systemic preoperative assessment and investigations to rule out associated anomalies have also been highlighted.","PeriodicalId":228896,"journal":{"name":"Journal of Anesthesia and Critical Care: Open access","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128357009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Could nebulized heparin be the magic treatment for COVID-19 Pneumonia and ARDS?","authors":"K. Sewify, Ahmed R Shoala, Abdelaziz Alshaer, A. Amin, Rehab Y AL-Ansari","doi":"10.15406/jaccoa.2021.13.00494","DOIUrl":"https://doi.org/10.15406/jaccoa.2021.13.00494","url":null,"abstract":"Background: The global spread of the novel strain of coronavirus referred to as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has resulted in the continuous rise in the hospitalization of people suffering from COVID-19 in various parts of the world. The predominant symptoms experienced by patients diagnosed with SARS-CoV-2 infection include pneumonia and acute respiratory distress syndrome (ARDS). These symptoms have contributed to the high mortality rate of COVID-19 patients across the globe. Recent studies have indicated that nebulized unfractionated heparin (UFH) can be employed in the treatment of pneumonia and acute respiratory distress syndrome (ARDS) in hospitalized patients who have been diagnosed with SARS-CoV-2 infection. Case description: The case study for this investigation was a 37-year-old Saudi woman who had muscular dystrophy, bronchial asthma, and diabetes mellitus. This hospitalized patient who was a wheelchair bound was admitted to the intensive care unit (ICU) due to the onset of severe COVID-19 related pneumonia and ARDS. The patient was intubated and placed on high mechanical ventilation support with protective lung strategy (low tidal volume and high PEEP level), prone positioning, administering inhaled nitric oxide therapy, and the intravenous infusion methylprednisolone together with antiviral agents and empiric antibiotics for seven days. Despite the administration of this maximal therapy, she continued to have refractory hypoxemia and severe ARDS. As a result, a high dose of UFH was administered to the patient through nebulization. After administering nine different doses of nebulized UFH, the patient’s oxygenation and inflammatory markers have remarkably improved, then she had a very smooth course and successfully weaned off mechanical ventilation. Conclusion: This treatment strategy resulted in a significant improvement in the P/F ratio, a remarkable reduction in the bilateral lung infiltrates and inflammatory markers and eventually weaning of mechanical ventilation in the COVID-19 patient. This case suggests that nebulized UFH has a strong scientific and biological basis to test its use as a therapy for COVID-19 pneumonia and ARDS as it may offer huge clinical benefit across the time course of the disease as well may prevent progression of infection If administered early at the onset of symptoms, and may finally prevent the needs for mechanical ventilation. Learning points: Randomized controlled trials should be carried out to investigate the clinical impacts of nebulized UFH in both prevention and treatment of COVID-19 pneumonia/AERDS.","PeriodicalId":228896,"journal":{"name":"Journal of Anesthesia and Critical Care: Open access","volume":"79 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130081746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ostomy – more than what you see... integrative literature review","authors":"Sandra Paula Morais de Matos","doi":"10.15406/jaccoa.2021.13.00492","DOIUrl":"https://doi.org/10.15406/jaccoa.2021.13.00492","url":null,"abstract":"Background: Taking into consideration the needs inherent in the new health-disease state, stoma marking can be a turning point in the whole process of transition. Thus, can be considered a factor inhibitor or facilitator, in part due to how it is diagnosed, seen and experienced. Objective: Understand the impact of preoperative stoma marking in context to patients undergoing colorectal surgery. Methodology: Bibliographical research, followed by analytical reading of selected articles and use of the theory of Afaf transitions as theoretical support. Results: The analysis of the scientific evidence, this orients to the recognition of the needs inherent to the candidate the ostomy. Conclusion: Preoperative marking of stoma in context is of great importance as it allows a diagnosis prior to planned nursing interventions associated with a contingency plan facilitates the healthy transition process, resulting in health gains.","PeriodicalId":228896,"journal":{"name":"Journal of Anesthesia and Critical Care: Open access","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114778875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case report: transcaval impella placement in a patient with acute lv dysfunction from ethylene glycol toxicity","authors":"Prashanth Singanallur MD, Nilesh Goswami MD, Govind Pandompatam MD, Muhammad Kashif Qaseem MD","doi":"10.15406/jaccoa.2021.13.00490","DOIUrl":"https://doi.org/10.15406/jaccoa.2021.13.00490","url":null,"abstract":"Introduction: Ethylene glycol is a toxic alcohol commonly found in antifreeze, or other household and industrial agents. Patients usually survive ethylene glycol toxicity when promptly treated but delay in care can cause significant morbidity and mortality. Significant metabolic acidosis can lead to multisystem organ dysfunction including Left ventricular dysfunction which can pose a unique challenge. Case report: The patient is a young female who presented with acute encephalopathy, intraventricular hemorrhage (IVH), severe metabolic acidosis, and severe left ventricular dysfunction following acute ethylene glycol toxicity. A diagnosis was quickly made due to presence of calcium oxalate crystals in the urine. The patient received timely interventions with Fomepizole and kidney replacement therapy (KRT), which failed to reverse her severe shock. The patient required mechanical circulatory support (MCS) in the form of Transcaval peripheral ventricular assist device (pVAD). Conclusion: This case showed the use of the transcaval approach to place an pVAD in a young patient suffering from ethylene glycol toxicity and severe left ventricular dysfunction. Although it remains an uncommon approach, it can be used when more traditional access points have failed, and the patient requires MCS.","PeriodicalId":228896,"journal":{"name":"Journal of Anesthesia and Critical Care: Open access","volume":"68 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121203881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Statin induced myopathy presenting as quadriparesis: a case report","authors":"S. Khanal, Kripa Kc, Supriya Lamichhane","doi":"10.15406/jaccoa.2021.13.00489","DOIUrl":"https://doi.org/10.15406/jaccoa.2021.13.00489","url":null,"abstract":"","PeriodicalId":228896,"journal":{"name":"Journal of Anesthesia and Critical Care: Open access","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121419973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determination of nephrotoxic effects due to Sugammadex and Rocuronium administration in rats","authors":"Ö. Uludağ, Z. Doğan, E. Annaç","doi":"10.15406/jaccoa.2021.13.00487","DOIUrl":"https://doi.org/10.15406/jaccoa.2021.13.00487","url":null,"abstract":"Background: Nowadays, neuromuscular blocker rocuronium and antagonizing sugammadex are being used in anesthesia practice. Rocuronium and sugammadex complexes are eliminated via the kidneys. The aim of this study was to investigate the effects of sugammadex and rocuronium plus sugammadex on histopathological evaluation and antioxidant status of kidney tissue for nephrotoxic effect. Material and method: The study included 32 Sprague-Dawley type rats. The experimental animals were randomized into four groups with equal numbers each containing 8 rats as follows; Sham Group 1, Control Group 2, Sugammadex Group 3, Rocuronium plus sugammadex Group 4. Kidneys were excised after practise. Kidney tissue histopathological evaluation and antioxidant status (measurements of MDA and GSH levels) were investigated. Results: In group 4 led to a insignificant decrease in GSH levels compared to other groups. MDA for Group 4 showed a statistically significant difference compared to all other groups. Histopathological evaluation in group 4, an increase in vascular congestion was detected and degeneration was observed in dilated tubules and tubule epithelium. In addition, dilatation was observed in the glomerular capillaries and the veins in the medulla region. Conclusion: According to our findings, Rocuronium plus sugammadex in the dose ranges used in the studies, caused histopathological degeneration in the kidneys.","PeriodicalId":228896,"journal":{"name":"Journal of Anesthesia and Critical Care: Open access","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129686062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric cardiopulmonary resuscitation: comparison between emergency department and inpatients setting at a tertiary academic hospital in Oman","authors":"Shilpa Ramachandran, Niranjan Lal, S. Panchatcharam, Marwan Al Raisi, S. Abri","doi":"10.15406/jaccoa.2021.13.00488","DOIUrl":"https://doi.org/10.15406/jaccoa.2021.13.00488","url":null,"abstract":"Objective: The aim of this study was to compare cardiopulmonary resuscitation (CPR) between emergency department (ED) and inpatients setting at Sultan Qaboos University Hospital (SQUH). Methods: The study was a retrospective cohort chart review of pediatric CPR at Sultan Qaboos University Hospital (SQUH) from January 2012 till August 2017. The CPR sheets were reviewed for four main variables: patient related, event related, treatment and outcomes. Results: A total of 83 cases were included, 48 males (58%) and 35 females (42%). Two Thirds of the patients (n=56) were in-patient; whereas one third of cases were from ED (n=27). Overall, most common cause for arrest that accounted 73.5% (n=61) was due to respiratory arrest. Events were more common in younger age group with 50% in less than 1 year (n=41). Bradycardia with hypo-perfusion represented most of arrest type 65% (n=54) followed by asystole 31% (n=26). Only 10% of patient survived to discharge (n=8). In comparison, 89% of ED arrest were unwitnessed. On the other hand, PICU and ward arrests predominantly were monitored 98% (n=55). ED patients’ survival appeared better at 19.2% (n=5) within 24hrs post arrest and 11.5% (n=3) within 1-year in comparison to PICU/Ward of 8.9% (n=5) survival within 24hrs and 1-year post event yet it was not statistically significant. Conclusion: The survival outcome in resuscitation was almost similar between ED & In-patient setting (PICU/wards) cardiopulmonary arrests despite having few significant differences based on variables. Overall, 10% of patients survived to discharge and higher survival rates are associated with duration of CPR less than 20 minutes . Intraosseous route is underutilized and should be applied earlier especially in ED to prevent delay in administration of resuscitation medications.","PeriodicalId":228896,"journal":{"name":"Journal of Anesthesia and Critical Care: Open access","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128719221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Panton-valentine leukocidin staphylococcus causing necrotising pneumonia in a young male","authors":"M. Noor, A. Chaudhry, O. Mirza","doi":"10.15406/jaccoa.2021.13.00482","DOIUrl":"https://doi.org/10.15406/jaccoa.2021.13.00482","url":null,"abstract":"Panton–Valentine leukocidin (PVL) is among one of the many toxins associated with Staphylococcus aureus infection. It commonly causes recurrent skin and soft tissue infections (SSTIs), but can sometimes be associated with severe invasive infections, including necrotising haemorrhagic pneumonia in otherwise healthy young people. Here we report a case of young male patient who presented with community acquired pneumonia that very rapidly progressed to necrotising haemorrhagic pneumonia leading to septic shock with multi-organ failure. His chest imaging showed extensive right sided cavitatory pneumonia & his bronchial washings confirmed the presence of PVL positive Staph aureus. He was managed in Intensive care where he was resuscitated with organs support along with broad spectrum antibiotics. He later developed renal impairment needing renal replacement therapy. Patient gradually showed clinical signs of improvement after prolonged ICU admission. He was later stepped down to the Respiratory ward following improvement in clinical condition. Hence medical physicians need to know about Panton–Valentine leukocidin (PVL) producing staphylococcus aureus as early detection and treatment can save lives of patients.","PeriodicalId":228896,"journal":{"name":"Journal of Anesthesia and Critical Care: Open access","volume":"32 7","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132845704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}