Assuntos
Reanimação Cardiopulmonar/métodos , Parada Cardíaca/terapia , Hipotermia Induzida/efeitos adversos , Traumatismo Múltiplo/terapia , Rabdomiólise/etiologia , Adulto , Reanimação Cardiopulmonar/efeitos adversos , Parada Cardíaca/complicações , Humanos , Masculino , Traumatismo Múltiplo/complicações , Rabdomiólise/fisiopatologiaRESUMO
We present the case of a healthy young male who developed acute respiratory failure as a result of infection with influenza A/H1N1 of swine-origin and in whom ventilatory support was optimised and recovery of lung function was monitored by the use of sequential chest ultrasound examinations. The potential pivotal role of bedside lung ultrasonography in H1N1-induced respiratory failure is discussed.
Assuntos
Vírus da Influenza A Subtipo H1N1/isolamento & purificação , Influenza Humana/diagnóstico por imagem , Pulmão/diagnóstico por imagem , Síndrome do Desconforto Respiratório/diagnóstico por imagem , Adulto , Cuidados Críticos/métodos , Humanos , Influenza Humana/complicações , Masculino , Síndrome do Desconforto Respiratório/virologia , Tomografia Computadorizada por Raios X , UltrassonografiaRESUMO
BACKGROUND: The use of low-dose dopamine (LDD; 0.5-2.5 mug/kg/min) in kidney transplant recipients seeks to increase urine output, prevent arterial vasospasm, and reduce the incidence of acute tubular necrosis. The aim of this study was to evaluate the effect of LDD in the early postoperative period (12 hours) among kidney transplant recipients. METHODS: We studied all kidney transplant recipients admitted to the Intensive Care Unit (ICU) in the early postoperative period from January 2004 to December 2008. A total of 105 patients were retrospectively assigned to two groups: group A (n = 57) was treated with LDD and group B (n = 48), not treated with LDD. All patients otherwise received the same therapy. Blood sample analysis and kidney function were recorded at 0, 6, and 12 hours after admission. For each patient, we collected the following data: donor and transplant kidney features, recipient demographics, intraoperative events, hemodynamic and kidney function parameters in the ICU, and outcomes. Patients were followed for 6 months after ICU discharge. RESULTS: Hourly diuresis and kidney function parameters showed no significant difference between the groups. Significant differences between group A and group B were observed in heart rate (92.63 +/- 14.18 vs 82.87 +/- 13.5, respectively), hours of ICU length of stay (29.0 +/- 17.42 vs 20.43 +/- 7.35, respectively), and 6-month mortality rate (8.8% vs 0%, respectively; P < .05). CONCLUSION: LDD prescription in kidney transplantation neither improved kidney function during the postoperative period nor short-term outcomes, but was associated with an increased heart rate, ICU length of stay and 6-month mortality.