Clinical significance of intraabdominal pressure and abdominal perfusion pressure in patients with acute abdominal syndrome (Views : 10184 times)
Abstract
Elevated intraabdominal pressure (IAP) has been claimed to play a role in abdominal compartment syndrome. We assessed the correlation between the values of IAP, abdominal perfusion pressure (APP) and clinical scoring systems including SIRS, MODS and APACHE II and the patients' survival rate in patients admitted to the ICU with acute abdomen due to ileus, intestinal perforation, peritonitis and trauma.
We measured IAP and APP in 50 surgical patients. In this study the IAP was measured in a non-invasive manner via urinary bladder pressure. The APP was calculated as the difference between mean arterial pressure and IAP values.
A significantly higher IAP was found in the non-survivors' group in comparison with the survivors' group. On the other hand, the APP inversely correlated with disease severity scores including SIRS, MODS and APACHE II, whereas IAP values did not show any correlation to these clinical parameters. These findings suggest that IAP and APP may be useful tools in the clinical evaluation of patients with acute abdomen.
Key words: intraabdominal pressure, abdominal perfusion pressure, acute abdominal syndrome
Early complications of percutaneous tracheostomy using the Griggs method (Views : 3239 times)
Written by:
Mladen Širanović, Saša Gopčević, Mijo Kelečić, Nataša Kovač, Valentina Krikšić, Bojan Rode, Marinko Vučić
Original articles
Abstract
This article presents our observations and experiences with the Griggs method of percutaneous dilation tracheostomy (PTD). We performed 200 tracheostomies on neurosurgical and surgical patients who needed temporary ventilatory support and protection. Early complications were defined and registered. Frequency of early complications was 22,5 %. The majority of complications were minor and improved quickly. Therefore, PTD was shown to be a safe and appropriate technique for patients treated in the intensive care unit (ICU). Unfortunately, lack of standardization and defined criteria deprive the opportunity for good comparisons between the Griggs method and other PTD methods.
Key words: percutaneous trache-ostomy, Griggs method, early compli-cations, surgery, neurosurgery
Early morning upper airway discomfort and appearance on two X ray films (Views : 2858 times)
Written by:
Hiroshi Dohgomori, Koji Yamakawa, Takehiko Furusawa
Case reports
Abstract
We reported a case of reversible but severe upper airway stenosis. The patient complained of only slight discomfort in her throat after waking: she had a history of allergic reaction to contrast medium. Her X ray films showed severe edema in her pharynx. Epiglottitis was diagnosed and we started treatment. It should not be forgotten, that even mild symptoms, such as discomfort in the throat, could indicate the existence of severe epiglottitis.
Key words: airway discomfort, airway stenosis, edema, epinephrine, ste-roids, epiglottitis
Hemorrhagic shock as a complication of anticoagulant therapy following the mitral valve replacement (Views : 2988 times)
Written by:
Tatjana Zah, Višnja Ivančan, Dinko Tonković, Željko Krznarić, Višnja Majerić Kogler, Igor Klinar
Case reports
Abstract
This report describes a case of the hemorrhagic shock in a patient on the anticoagulant therapy supplementing implanted mechanical prosthetic heart valve replacing the mitral valve. The association between hemorrhagic shock, mechanical prosthetic heart valve and anticoagulant therapy is briefly discussed.
Key words: hemorrhagic shock, mechanical prosthetic heart valve, anticoagulant therapy
Recombinant factor Vlla therapy in a patient on long term anticoagulant treatment with a bleeding and acute subdural hematoma (Views : 1998 times)
Written by:
Nataša Kovač, Aleksandar Gopčević, Josip Kovač, Mladen Novkoski, Petar Gaćina
Case reports
Abstract
In this paper we report on the successful correction of a coagulopathy with activated recombinant factor seven (rFVIIa) therapy which enabled surgical removal of a life threatening subdural hematoma. The severe coagulopathy developed due to long term warfarin therapy, which followed heart valvular reconstruction and replacement. The coagulopathy failed to improve following fresh frozen plasma and vitamin K therapy. Activated recombinant factor VII therapy became the treatment of choice, which enabled the life saving surgical removal of the subdural hematoma.
Key words: activated recombinant factor seven, subdural hematoma, anticoagulant therapy, neurosurgery.
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