Asunto(s)
Cateterismo de Swan-Ganz/efectos adversos , Cateterismo de Swan-Ganz/normas , Ensayos Clínicos Controlados Aleatorios como Asunto , Proyectos de Investigación/normas , Evaluación de la Tecnología Biomédica , Sesgo , Cuidados Críticos , Humanos , Guías de Práctica Clínica como Asunto , Evaluación de la Tecnología Biomédica/métodos , Evaluación de la Tecnología Biomédica/tendenciasAsunto(s)
Cateterismo de Swan-Ganz/efectos adversos , Cateterismo de Swan-Ganz/normas , Competencia Clínica/normas , Conocimientos, Actitudes y Práctica en Salud , Personal de Salud/educación , Personal de Salud/psicología , Sesgo , Falla de Equipo , Hemodinámica , Humanos , Monitoreo Fisiológico/instrumentación , Monitoreo Fisiológico/métodos , Monitoreo Fisiológico/normas , Selección de Paciente , Reproducibilidad de los ResultadosRESUMEN
Clinicians are confronted with a complex challenge when a patient is admitted to a critical care unit (CCU) with a significant chest roentgenography (CXR) abnormality. The etiology of a new infiltrate seen on CXR in a patient already in the CCU is more difficult to establish, but is of equal concern.
Asunto(s)
Cuidados Críticos/métodos , Enfermedades Pulmonares/diagnóstico por imagen , Neumonía/diagnóstico por imagen , Diagnóstico Diferencial , Humanos , Unidades de Cuidados Intensivos , Enfermedades Pulmonares/etiología , RadiografíaRESUMEN
Aspiration is the result of dysfunction during the oral, pharyngeal, or esophageal stage of deglutition. Depending on the type of aspirate, the resultant lung injury may include chemical or bacterial inflammation or obstruction of the airways. Tools for evaluation include roentgenography, upper GI tract studies, bronchoscopy, and esophageal pH studies. Medical management is primarily supportive. Because aspiration pneumonia has a high morbidity rate, prevention involving early recognition and modification of predisposing factors whenever possible is critical for improving outcomes.
Asunto(s)
Neumonía por Aspiración/diagnóstico , Humanos , Neumonía por Aspiración/etiología , Neumonía por Aspiración/prevención & control , Neumonía por Aspiración/terapiaAsunto(s)
Síndrome de Dificultad Respiratoria , Adulto , Humanos , Mediadores de Inflamación/fisiología , Pulmón/patología , Pulmón/fisiopatología , Respiración Artificial , Síndrome de Dificultad Respiratoria/diagnóstico , Síndrome de Dificultad Respiratoria/fisiopatología , Síndrome de Dificultad Respiratoria/terapiaRESUMEN
Laparoscopic surgery is very popular among physicians and patients because this technique is associated with safety, shorter hospital stay, early return to normal activity, and cosmetic acceptance of the operative scar. Although the procedure involves minimal invasion and tissue damage, it has potentially serious complications, including cardiopulmonary effects that result mainly from hypercarbia and raised intraabdominal pressure caused by pneumoperitoneum. Absorbed carbon dioxide from the peritoneal cavity tends to cause acidosis. Leakage of the gas into tissue spaces may induce subcutaneous emphysema, pneumothorax, pneumomediastinum and pneumopericardium. Cardiac effects include arrhythmias, hypotension, cardiac arrest, gas embolism, pulmonary edema, and myocardial ischemia or infarction. Some of these effects, though rare, are serious and potentially fatal. Physicians should anticipate these problems in their patients undergoing laparoscopic procedures. This review discusses the technique of and physiologic considerations in laparoscopic surgery as well as its potential complications.
Asunto(s)
Laparoscopía , Enfermedades Cardiovasculares/etiología , Colecistectomía Laparoscópica , Hemodinámica , Humanos , Laparoscopía/efectos adversos , Neumoperitoneo Artificial , Enfermedades Respiratorias/etiologíaAsunto(s)
Neoplasias Pulmonares/diagnóstico por imagen , Linfoma de Células B de la Zona Marginal/diagnóstico por imagen , Neumonía/diagnóstico por imagen , Enfermedad Crónica , Humanos , Neoplasias Pulmonares/complicaciones , Linfoma de Células B de la Zona Marginal/complicaciones , Masculino , Persona de Mediana Edad , Neumonía/complicaciones , RadiografíaRESUMEN
We report on a 55-year-old woman with a tracheostomy who had unexplained respiratory failure from acute nocturnal shortness of death. During the second day of admission, the patient noticed that her "second chin" folded over the tracheostomy on neck flexion, occluding her artificial way. The patient jury-rigged a strap to retain the submental tissue from occluding the opening of the tracheostomy tube. She was subsequently free from obstructive symptoms with good oxygen saturation even with neck flexion. She was consequently discharged with a presumptive diagnosis of acute upper airway obstruction. We believe that this unusual complication of the tracheostomy tube may be more common than appreciated. Accordingly, patients with a tracheostomy should be evaluated through a full range of body and neck positions. Increases in body fat and tissue relaxation should be suspected as possible causes occlusion of tracheostomy tubes. The application of a "chin sling" can reverse this unusual upper airway obstruction until definitive correction by surgical lipectomy is performed.