Extracorporeal life support (ECLS) with a roller pump system uses a closed cardiopulmonary bypass (CPB) circuit not equipped with a venous reservoir. Hence, gas emboli cannot escape the ECLS circuit, predisposing to clot formation, membrane failure and potential gas embolism. Rarely, some patients may develop a continuous release of gas into the venous circulation from multiple sources. Two pediatric ECLS cases are presented with continuous venous gas embolism. A 'gas trap' was devised by creating a column of fluid erected vertically on the venous line. This allowed gas to rise within the column, separating it from the ECLS circuit, thus, preventing gas from lodging in the membrane.
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http://dx.doi.org/10.1191/0267659104pf756oa | DOI Listing |
Injury
January 2025
Washington University School of Medicine, Department of Surgery, Section of Acute and Critical Care Surgery, USA. Electronic address:
Traumatic brain injury (TBI) remains a leading cause of morbidity and mortality among trauma patients. The care of these patients continues to be a complex endeavor with prevention of associated complications, often requiring as much attention as that of the treatment of the primary injury. Paramount among these are venous thromboembolic events (VTE) due to their high incidence, additive effect on the risk of morbidity and mortality, and the careful balance that must be utilized in their diagnosis and treatment to prevent progression of the brain injury itself.
View Article and Find Full Text PDFJ Crit Care
January 2025
AP-HP, Hôpital Louis Mourier, DMU ESPRIT, Service de Médecine Intensive Réanimation, F-92700 Colombes, France; Université Paris Cité, Medical school, F-75018 Paris, France; Université Paris Cité, INSERM UMR-S1151, CNRS UMR-S8253, Institut Necker Enfants Malades, F-75015 Paris, France. Electronic address:
The optimal modalities of kidney replacement therapy (KRT) in the ICU remain debated. Intermittent haemodialysis (IHD) and continuous veno-venous haemofiltration (CVVH) are the two main methods. Intermittent haemodialysis requires a water treatment system, which may not be available in all jurisdictions.
View Article and Find Full Text PDFIntroduction: In the United States, deep vein thrombosis (DVT) and pulmonary embolism (PE) ranked high in terms of possibly preventable hospital deaths. Victims of trauma were at a higher risk of developing thromboembolic complications, and thus various agents were used for prophylaxis. Multiple studies recommended holding these agents in the perioperative period to decrease the potential complications of additional bleeding, wound issues, hematoma etc.
View Article and Find Full Text PDFClin Neurol Neurosurg
January 2025
Department of Neurosurgery & Brain Repair, University of South Florida, Tampa, FL, USA. Electronic address:
Introduction: Dural arteriovenous fistulas (dAVF) are abnormal anastomoses between meningeal arteries and dural venous sinuses. Typically, dAVF treatment involves an endovascular or microsurgical approach. Anterior ethmoidal artery (AEA) dAVFs pose unique challenges due to their anatomy and location.
View Article and Find Full Text PDFAnn Intensive Care
January 2025
Department of Intensive Care Medicine, Universitaire Ziekenhuis Brussel (UZ Brussel), Vrije Universiteit Brussel (VUB), Brussels, Belgium.
Background: Continuous veno-venous hemodiafiltration (CVVHDF) is used in critically ill patients, but its impact on O₂ and CO₂ removal, as well as the accuracy of resting energy expenditure (REE) measurement using indirect calorimetry (IC) remains unclear. This study aims to evaluate the effects of CVVHDF on O₂ and CO₂ removal and the accuracy of REE measurement using IC in patients undergoing continuous renal replacement therapy.
Design: Prospective, observational, single-center study.
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