RESUMEN
The objective of the review was to determine the long-term outcomes of necrotising pneumonia (NP). Studies published since 1990 in English, Portuguese, or Spanish, published on PubMed and Scielo were evaluated. Our findings showed ultrasound scanning is the diagnostic modality of choice. Despite prolonged hospitalisation (median 13-27 days) and fever (median 9-16 days), most patients recover completely. Empyema and bronchopleural fistulae are frequent in bacterial NP. Streptococcus pneumoniae is the most prevalent cause. Seventeen studies with 497 patients followed for 30 days to 8.75 years showed that most patients were clinically asymptomatic and had normal lung function. X-ray or CT chest imaging demonstrated that almost all lung lesions recovered within 4-6 months. We suggest that it is not necessary to request frequent chest X-rays during the treatment and recovery process. Chest CT scans should be reserved for specific cases not following the expected clinical course.
RESUMEN
PURPOSE: This report describes the implantation of a new design of intramuscular electrode to the diaphragm and introduces a new modality of electroventilation for diaphragmatic pacemaker. DESCRIPTION: We used 22 Large White female pigs to test 68 electrodes that were implanted in the abdominal portion of the diaphragm by videolaparoscopy. Animals were submitted to a new protocol of electroventilation with an unpolarized current and a single-channel mode with 1 electrode for each hemidiaphragm during 3 hours. EVALUATION: The electrodes were easily fixed to the diaphragm with the help of a deployment device designed for this purpose. There was no evidence of clinical complications such as pneumothorax or bleeding. No significant differences were observed in arterial blood gas analysis and serum lactate levels. CONCLUSIONS: The designed electrodes provided an excellent performance in connection between the electrical stimulator and the muscle tissue. The proposal for using an unpolarized current proved to be effective in stimulating both hemidiaphragms simultaneously with only a single channel of the electrical stimulator.