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Drive Pressure-Guided Individualized Positive End-Expiratory Pressure in Traumatic Brain Injury Surgery: A Randomized Controlled Trial.
Ann Ital Chir
December 2024
Department of Anesthesiology, Institute of Anesthesia, Emergency and Critical Care, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, 225002 Yangzhou, Jiangsu, China.
Aim: Intraoperative lung-protective ventilation strategies (LPVS) have been shown to improve lung oxygenation and prevent postoperative pulmonary problems in surgical patients. However, the application of positive end-expiratory pressure (PEEP)-based LPVS in emergency traumatic brain injury (TBI) has not been thoroughly explored. The purpose of this study is to evaluate the effects of drive pressure-guided individualized PEEP on perioperative pulmonary oxygenation, postoperative pulmonary complications, and recovery from neurological injury in patients with TBI.
View Article and Find Full Text PDFA Case Report Describing the Surgical Removal of Venous and Intracardiac Cement Leakage after Percutaneous Vertebroplasty in a Hybrid Operating Room.
Ann Ital Chir
December 2024
Department of Cardiovascular Surgery, Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy; Department of Biomedical, Surgical, and Dental Sciences, University of Milan, 20122 Milan, Italy.
Aim: Percutaneous vertebroplasty is generally considered a safe procedure, however, cases of cardioembolism and cardiac perforation have been reported.
Case Presentation: A 69-year-old woman was referred to our emergency department after an outpatient echocardiogram revealed a "thrombus-like" formation involving the right heart. Two weeks before she had undergone percutaneous vertebroplasty of the third to fifth lumbar vertebrae due to osteoporotic fractures.
Our Experience about Shared Venous Hemodynamics Map (SVHM): A Least Common Denominator for Computerized Comparison of the Results of Chronic Venous Disease (CVD) Treatment.
Ann Ital Chir
December 2024
Multidisciplinary Department of Medical-Surgical and Dental Specialties, Plastic Surgery Unit, Università degli Studi della Campania "Luigi Vanvitelli", 80138 Naples, Italy.
Aim: Varicose veins, while frequently perceived as a cosmetic concern, should be evaluated within the broader context of chronic venous insufficiency (CVI) affecting the lower extremities. The Mappa Emodinamica Venosa Condivisa, Italian for Shared Venous Hemodynamics Map (MEVeC) project aims to provide an objective method for assessing the hemodynamic disorders underlying CVI and standardizing the evaluation of therapeutic interventions for lower extremity CVI. To achieve objective treatment assessment, it is essential to ensure uniform expertise among phlebologists and the ability to replicate comparable clinical outcomes.
View Article and Find Full Text PDFSafe Laparoscopic Treatment of a Giant Hepatic Cyst That Compressed the Inferior Vena Cava With Severe Kyphosis.
Asian J Endosc Surg
December 2024
Department of Surgery and Science, Faculty of Medicine, Academic Assembly, University of Toyama, Toyama, Japan.
We report a case in which a giant hepatic cyst located at the hepatic hilum and compressing the inferior vena cava was safely treated laparoscopically with careful attention to hemodynamics in a difficult fenestrated resection in a patient with severe kyphosis. The anatomic location of the cyst was evaluated preoperatively via 3D reconstruction of computed tomography images to identify a site where safe fenestrated resection could be performed. This was challenging because the surgical field was narrow due to the presence of severe kyphosis, and there was a risk of damage to surrounding organs during fenestrated resection.
View Article and Find Full Text PDFMixed Cardiogenic-Vasodilatory Shock: Current Insights and Future Directions.
JACC Adv
January 2025
Division of Cardiology, Department of Medicine, Warren Alpert Medical School of Brown University, and Lifespan Cardiovascular Institute, Providence, Rhode Island, USA.
This state-of-the-art review describes the potential etiologies, pathophysiology, and management of mixed shock in the context of a proposed novel classification system. Cardiogenic-vasodilatory shock occurs when cardiogenic shock is complicated by inappropriate vasodilation, impairing compensatory mechanisms, and contributing to worsening shock. Vasodilatory-cardiogenic shock occurs when vasodilatory shock is complicated by myocardial dysfunction, resulting in low cardiac output.
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