RESUMEN
Paciente de 49 años (IMC 29,4 kg/m2 y ASA III) con estenosis subglótica (ES) de más de 70% (grado III) intervenida mediante resección láser y posterior dilatación. Durante la resección láser se empleó ventilación controlada por flujo utilizando el respirador Evone®, que permite controlar todo el ciclo respiratorio regulando tanto el flujo inspiratorio como el espiratorio sin comprometer el intercambio gaseoso a pesar de administrar FIO2 máxima de 0,3 por riesgo de ignición. Antes de proceder a la dilatación endoscópica, se retiró el tubo endotraqueal láser de 4,5 mm de diámetro interno y se inició terapia con gafas nasales de alto flujo (GNAF) para prolongar la oxigenación apneica. El tiempo total de apnea fue de 11 minutos, manteniendo en todo momento SpO2 > 98% y End Tidal de CO2 máximo de 60 mmHg.(AU)
A 49-year old patient (BMI 29.4 kg/m2 and ASA III) with grade III subglottic stenosis (> ventilator in flow controlled ventilation mode, which allowed us to regulate both inspiratory and expiratory flow without compromising gas exchange despite maintaining peak FIO2 at 0.3 due to the risk of ignition. Before proceeding with endoscopic dilation, the 4.5 mm laser endotracheal tube was withdrawn and high flow nasal cannula oxygenation was started in order to prolong apnoeic oxygenation. Total apnoea time was 11 minutes, maintaining SpO2 > 70%) underwent laser resection followed by dilation. During resection he was ventilated by the Evone > ventilator; high flow nasal cannula therapy; apnoeic oxygenation-98% and peak EtCO2 60 mmHg throughout the procedure.(AU)
Asunto(s)
Humanos , Femenino , Persona de Mediana Edad , Laringoestenosis/cirugía , Oxigenación , Terapia por Láser , Laringoestenosis/etiología , Intubación Intratraqueal , Pacientes Internos , Examen Físico , Evaluación de SíntomasRESUMEN
A 49-year old patient (BMI 29.4kg/m2 and ASA III) with grade III subglottic stenosis (> ventilator in flow controlled ventilation mode, which allowed us to regulate both inspiratory and expiratory flow without compromising gas exchange despite maintaining peak FIO2 at 0.3 due to the risk of ignition. Before proceeding with endoscopic dilation, the 4.5mm laser endotracheal tube was withdrawn and high flow nasal cannula oxygenation was started in order to prolong apnoeic oxygenation. Total apnoea time was 11min, maintaining SpO2>70%) underwent laser resection followed by dilation. During resection he was ventilated by the Evone>ventilator; high flow nasal cannula therapy; apnoeic oxygenation-98% and peak EtCO2 60mmHg throughout the procedure.
Asunto(s)
Laringoestenosis , Terapia por Láser , Masculino , Humanos , Persona de Mediana Edad , Oxígeno , Constricción Patológica , Respiración Artificial , Terapia por Inhalación de Oxígeno/métodos , Laringoestenosis/cirugíaAsunto(s)
Anticoagulantes/farmacología , Artefactos , Recolección de Muestras de Sangre/métodos , Ácido Edético/farmacología , Agregación Plaquetaria/efectos de los fármacos , Recuento de Plaquetas , Trombocitopenia/diagnóstico , Adolescente , Antígenos de Plaqueta Humana/efectos de los fármacos , Antígenos de Plaqueta Humana/inmunología , Pérdida de Sangre Quirúrgica , Crioglobulinas/inmunología , Recuento de Eritrocitos , Humanos , Masculino , Meningomielocele/cirugía , Periodo Posoperatorio , Escoliosis/cirugía , Fusión VertebralRESUMEN
No disponible
Asunto(s)
Humanos , Masculino , Adolescente , Trombocitopenia/complicaciones , Trombocitopenia/diagnóstico , Ácido Edético/efectos adversos , Recuento de Plaquetas/instrumentación , Recuento de Plaquetas , Trombocitopenia/terapia , Agregación Plaquetaria , Idiotipos de Inmunoglobulinas/clasificación , Inmunoglobulinas/análisis , Inmunoglobulinas/sangreAsunto(s)
Anestesia Epidural/métodos , Anestesia Obstétrica/métodos , Cesárea , Distrofia Muscular de Cinturas/complicaciones , Complicaciones del Trabajo de Parto/etiología , Inercia Uterina/etiología , Adulto , Anestesia General , Contraindicaciones , Femenino , Humanos , Recién Nacido , Masculino , Oxitocina/uso terapéutico , Embarazo , Inercia Uterina/tratamiento farmacológicoRESUMEN
A study was made to determine the prevalence of anemia in apparently healthy children of both sexes aged 6 to 24 months attending the preventive medicine service in a general hospital of the Mexican Social Security Institute in the city of Tapachula, State of Chiapas. One hundred children were studied with a capillary hemoglobin (Hb) determination: 91 had anemia (Hb less than or equal to 11 g/dL). Sixty eight of the anemic children received oral iron for 3 months (3 mg/kg/day): their Hb before and after iron therapy were compared. Considering as responders those with an increment in Hb greater than 1 g/dL, sixty four children (94%) showed a mean increment of 2.6 g/dL. Four were considered as non-responders: in 3 the iron supplementation was stopped due to infectious diseases; the fourth case had a Hb increment below 1 g/dL. The use of capillary Hb as a criterium for treating anemic children proved to be a good predictor of response in a population where the prevalence of iron deficiency is high.
