Maternal Salvage With Extracorporeal Life Support: Lessons Learned in a Single Center.

The American Heart Association scientific statement on cardiac arrest in pregnancy did not endorse extracorporeal life support for lack of cohort data. We studied all pregnancy and peripartum cases of extracorporeal life support in 1 medical center (n = 11), including collapse due to infection (n = 6, 55%), thromboembolism (n = 3, 27%), and cardiac disease (n = 2, 18%). Half of the cases (n = 5, 45%) involved extracorporeal cardiopulmonary resuscitation.

Extracorporeal life support in patients with multiple injuries and severe respiratory failure: a single-center experience?

Background: The use of extracorporeal life support in trauma casualties is limited by concerns regarding hemorrhage, particularly in the presence of traumatic brain injury (TBI). We report the use of extracorporeal membrane oxygenation (ECMO)/interventional lung assist (iLA) as salvage therapy in trauma patients. High-flow technique without anticoagulation was used in patients with coagulopathy or TBI.

Antibiotic prophylaxis in cardiac surgery: systematic review and meta-analysis.

Background: Antibiotic prophylaxis is recommended in cardiac surgery. Current debate concerns the type of antibiotic(s), dosing and the duration of prophylaxis.

Methods: Systematic review of randomized controlled trials comparing one antibiotic regimen versus another in cardiac surgery.

Retrosternal percutaneous tracheostomy: an approach for predictably impossible classic tracheostomy.

Percutaneous tracheostomy is a routine procedure in intensive care units. In cases of very low position of the larynx, cervical spine deformation, morbid obesity, or neck tumor, performance of the classic tracheostomy is inapplicable. Retrosternal approach to tracheostomy in such 20 patients is herein reported.

A-lines and B-lines: lung ultrasound as a bedside tool for predicting pulmonary artery occlusion pressure in the critically ill.

Background: The risk of pulmonary edema is the main limiting factor in fluid therapy in the critically ill. Interstitial edema is a subclinical step that precedes alveolar edema. This study assesses a bedside tool for detecting interstitial edema, lung ultrasound.

Reliability of cardiac output calculation by the fick principle and central venous oxygen saturation in emergency conditions.

Background: For many years thermodilution has been the gold standard for determining cardiac output in the critically ill patients. Less invasive methods have recently been introduced. This study aimed at evaluating the agreement between cardiac output (CO) measured by a new Fick method, using central venous saturation (Scvo(2)), and that measured by the classic thermodilution technique, in patients requiring emergent CO evaluation.

The quinary pattern of blast injury.

Objective: Bombing is the primary weapon of global terrorism, and it results in a complicated, multidimensional injury pattern. It induces bodily injuries through the well-documented primary, secondary, tertiary, and quaternary mechanisms of blast. Their effects dictate special medical concern and timely implementation of diagnostic and management strategies.

Inhaled nitric oxide improves pulmonary functions following massive pulmonary embolism: a report of four patients and review of the literature.

Acute pulmonary embolism increases pulmonary vascular resistance and may lead to acute right ventricular failure and cardiocirculatory collapse and respiratory failure, possibly resulting in substantial morbidity and mortality. Inhaled nitric oxide (NO) dilates pulmonary blood vessels and has been used to reduce pulmonary vascular resistance in patients with chronic thromboembolic pulmonary hypertension and acute respiratory distress syndrome. This case series describes our experience with inhaled NO administered to four patients suffering from acute massive pulmonary embolism following abdominal surgery.

Ultrasound diagnosis of occult pneumothorax.

Objectives: Pneumothorax can be missed by bedside radiography, and computed tomography is the current alternative. We asked whether lung ultrasound could be of any help in this situation.

Design: Retrospective study.

Tracheal mucormycosis presented as an intraluminal soft tissue mass.

Background: Mucormycosis is a potentially lethal disease caused by an opportunistic fungal infection. It occurs mostly in diabetic or immunosuppressed patients and usually involves the lungs or paranasal sinuses.

Methods: We report a rare case of a patient with diabetic ketoacidosis who presented with progressive cough and dyspnea.

Gray-white matter discrimination--a possible marker for brain damage in heat stroke?

Introduction/objective: Heat stroke (HS) is a common medical emergency which carries high morbidity and morality. This study was designed to describe the pattern of central nervous system (CNS) changes as detected by brain CT scan in a case series of six patients suffering from classical and exertional HS.

Methods And Patients: All the patients were admitted in critical condition during the heat wave in the summer of 1999 in Israel.