Endoscopic third ventriculostomy (ETV) is a relatively safe procedure. However, postoperative acute respiratory failure may be fatal. The authors report an 8-month-old patient with obstructive hydrocephalus secondary to posterior fossa cyst, and Chiari malformation. After ETV he developed difficulty in breathing, and had to be reintubated and ventilated. The infant recovered fully after craniocervical decompression and insertion of cystoperitoneal shunt. We speculate that respiratory failure is related to relative expansion of the posterior fossa arachnoid cyst, causing significant compression on the brain stem. Supportive care with mechanical ventilation and brain stem decompression were the mainstay of treatment.
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http://dx.doi.org/10.4103/1658-354X.105894 | DOI Listing |
Gastroenterol Clin North Am
March 2025
Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi 110029, India. Electronic address:
Organ failure (OF) is a sinister development in the clinical course of acute pancreatitis, and its prediction is crucial for triaging the patient. Persistent systemic inflammatory response syndrome and raised interleukin-6 levels have a good predictive accuracy. Pathophysiology involves the release of damage-associated molecular patterns as a consequence of pancreatic injury, recruitment of inflammatory cells, and the release of proinflammatory cytokines and chemokines causing cytokine storm.
View Article and Find Full Text PDFClin Microbiol Infect
January 2025
Department of internal medicine and liver research institute, Seoul national university hospital, Seoul national university college of medicine, Seoul, Republic of Korea. Electronic address:
Objectives: This study evaluated the adequacy of using blood cultures alone for antibiotic therapy in mild-to-moderate acute cholangitis after adequate biliary drainage.
Methods: A prospective, multi-centre, non-inferiority, randomised trial was conducted from August 2015 to September 2023 across 12 tertiary hospitals in South Korea. Patients were randomly assigned 1:1 to groups.
J Pediatr Surg
January 2025
Division of Pediatric Surgery, Department of Surgery, Phoenix Children's Hospital, Phoenix AZ, USA.
Background: Although Extracorporeal Membrane Oxygenation (ECMO) utilization in pediatric patients with cardiopulmonary failure due to infection improves mortality, it is unclear whether the infectious etiology impacts outcomes. The aim of this study is to compare ECMO outcomes in children with sepsis and severe acute lung injury secondary to infections based on culture data.
Methods: A retrospective review was done of patients aged <18 with severe infections whose management included ECMO from 2013 to 2022 at a quaternary children's hospital.
Phytomedicine
January 2025
West China Centre of Excellence for Pancreatitis, Institute of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, PR China.. Electronic address:
Background: Chaiqinchengqi decoction, a traditional Chinese medicine, has shown promising effects in in vitro, animal and preliminary small human studies for acute pancreatitis, but evidence of clinical practice is limited.
Purpose: To investigate whether Chaiqinchengqi decoction could improve clinical outcomes in patients with acute pancreatitis.
Study Design: Prospective, pragmatic, randomized controlled trial.
Crit Care Sci
January 2025
Anaesthesiology and Critical Care, All India Institute of Medical Sciences - Jodhpur, India.
Objective: Although the efficacy of high-flow nasal oxygen therapy in delaying or avoiding intubation in patients with hypoxemic respiratory failure has been studied, its potential for facilitating early weaning from invasive mechanical ventilation remains unexplored.
Methods: In this randomized controlled trial, 80 adults with acute hypoxemic respiratory failure requiring invasive mechanical ventilation for > 48 hours were enrolled and divided into two groups: conventional weaning and early weaning via high-flow nasal oxygen. In the conventional weaning group, the spontaneous breathing trial was performed after the PaO2/FiO2 ratio was ≥ 200, whereas in the high-flow nasal oxygen group, the spontaneous breathing trial was conducted earlier when the PaO2/FiO2 ratio was 150 - 200.
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