RESUMO
Image-guided interventional techniques have markedly altered the management of many cardiothoracic problems in the intensive care unit. These techniques are less invasive, more patient friendly, and cost-effective. This article covers venous line placement and management, transpleural and transpulmonary biopsy and drainage procedures and interventions for variceal bleeding, massive hemoptysis, massive pulmonary embolism, and veno-occlusive disease.
Assuntos
Cuidados Críticos , Pneumopatias/terapia , Radiografia Intervencionista , Tromboembolia/terapia , Biópsia por Agulha , Cateterismo Venoso Central , Drenagem , Feminino , Humanos , Unidades de Terapia Intensiva , Pulmão/patologia , Pneumopatias/diagnóstico por imagem , Pneumopatias/patologia , Masculino , Tromboembolia/diagnóstico por imagemRESUMO
PURPOSE: To evaluate percutaneous fibrin sleeve stripping (PFSS) to prolong functional patency in failing hemodialysis catheters. MATERIALS AND METHODS: Forty PFSS procedures were performed in 24 catheters in 23 consecutive patients with an inadequate blood flow rate (< 200 mL/min) during hemodialysis. The fibrin sleeve was mechanically stripped off the shaft of the catheter with a snare introduced via the common femoral vein. Durability of PFSS was determined with life-table analysis. RESULTS: Median time from catheter placement to initial failure was 3.5 months (range, 5 days to 22 months). The technical success rate for PFSS was 100%; initial patency was restored in 39 of 40 procedures (98%), and no symptomatic pulmonary embolism occurred. Primary patency after single PFSS was 45% at 3 months and 28% at 6 months (median added patency, 2.8 months). Postprocedure secondary patency with multiple PFSS procedures was 83% at 3 months and 72% at 6 months (P = .01) (overall catheter patency, 90% at 6 months and 81% at 1 year [P < .001]). CONCLUSION: Multiple PFSS procedures can prolong patency in hemodialysis catheters with a fibrin sleeve.
Assuntos
Cateteres de Demora/efeitos adversos , Radiografia Intervencionista/métodos , Diálise Renal , Adulto , Idoso , Idoso de 80 Anos ou mais , Velocidade do Fluxo Sanguíneo , Cateterismo Venoso Central/efeitos adversos , Feminino , Fibrina , Humanos , Masculino , Pessoa de Meia-Idade , PunçõesAssuntos
Dente Canino , Erupção Ectópica de Dente/terapia , Técnicas de Movimentação Dentária , Dente Impactado/terapia , Dente Pré-Molar , Criança , Feminino , Humanos , Má Oclusão Classe I de Angle/terapia , Má Oclusão Classe II de Angle/terapia , Mandíbula , Técnicas de Movimentação Dentária/instrumentaçãoAssuntos
Aneurisma/diagnóstico por imagem , Artéria Poplítea , Idoso , Feminino , Humanos , CintilografiaAssuntos
Dilatação Gástrica/etiologia , Distrofias Musculares/complicações , Doença Aguda , Adulto , Humanos , MasculinoRESUMO
Possible relationships of six personal characteristics reported on application blanks and job tenure of hospital dietary employees were statistically analyzed. By chisquare analysis, three characteristics--age (forty-six years or older), marital status (widowed or divorced), and education (less than nine years)--appeared to be positively related to longer tenure (over six months). However, multiple regression analysis to determine the combined effect of all variables indicated no relationship which could be used to predicting tenure when employing dietary workers.
