Intracerebral structures and pathologies such as intracerebral hemorrhages (ICH) can be displayed sufficiently by transcranial sonography (TCS). In some patients with ICH clot evacuation via surgery or catheter drainage to reduce secondary parenchymal injuries may be necessary. We hypothesized that bedside-placement of drainage-catheters, which is a minimal invasive evacuation-technique complicated by a higher rate of catheter misplacement can be optimized via TCS. Eleven consecutive ICH-patients diagnosed via computertomography (CT) were included in this prospective observational pilot study. All patients were examined via TCS, firstly in order to illustrate the hematoma, secondly to optimize catheter placement. Catheter placement was primarily validated via CT. The TCS-depiction of ICH-extension was optimal in 10 patients; one patient showed a partially insufficient transtemporal bone window. Catheter positioning could be traced and adapted correctly via TCS-examination in all patients. Follow-up CT-scans confirmed TCS-description of catheter-positioning in all patients without any complications. Reduction of symptoms and ICH-volumes confirmed effectiveness of treatment. The illustration of ICH and the drainage-placement is possible via TCS in a cost- and time-efficient way.
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http://dx.doi.org/10.3389/fneur.2018.00651 | DOI Listing |
Mediastinum
May 2024
Department of Interventional Radiology, Division of Diagnostic Imaging, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
The mediastinal vasculature can be affected by various etiologies in cancer patients. Both direct and indirect sequela of cancer may result in life-threatening clinical presentations. Tumor growth may cause vessel narrowing and decreased blood flow from either extrinsic mass effect, invasion into the vascular wall, or tumor thrombus within the lumen.
View Article and Find Full Text PDFCureus
December 2024
Anesthesiology, Showa University Northern Yokohama Hospital, Yokohama, JPN.
Flail chest is a life-threatening condition characterized by multiple rib fractures that result in a partially free rib cage. Thoracic paravertebral block (TPVB) allows visualization of the needle tip under ultrasound guidance and can be safely performed, unlike epidural anesthesia where the needle tip cannot be visualized. Here, we describe a case of flail chest in whom TPVB was used, as it provides the same level of analgesia as epidural anesthesia and has a perfect analgesic effect.
View Article and Find Full Text PDFJTCVS Open
December 2024
Department of Cardiac Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Mass.
Background: Perioperative right ventricular (RV) dysfunction is associated with increased morbidity and mortality in cardiac surgery patients. This study aimed to demonstrate proof of concept in generating intraoperative RV pressure-volume (PV) loops and conducting an end-systolic PV relationship (ESPVR) analysis using data obtained from routinely used intraoperative monitors.
Methods: Adult patients undergoing cardiac surgery with the placement of a pulmonary artery catheter (PAC) between May 2023 and March 2024 were included prospectively.
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
December 2024
Department of Critical Care Medicine, Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, Shandong, China. Corresponding author: Zhang Jicheng, Email:
Objective: To provide evidence for further reducing the incidence of central line-associated bloodstream infection (CLABSI) according to investigation of the prevention and control of CLABSI in intensive care unit (ICU) in Shandong Province.
Methods: The questionnaire was developed by experts from Shandong Critical Care Medical Quality Control Center, combining domestic and foreign guidelines, consensus and research. A convenient sampling method was used to recruit survey subjects online from October 11 to 31, 2023 in the province to investigate the management status of central venous catheter (CVC) in ICU units of secondary and above hospitals.
N Engl J Med
January 2025
From the University of Queensland, Brisbane, QLD, Australia (A.J.U., D.A., T.M.K., N.M., N.R., P.L.-A., V.G., A.C., P.M., C.M.R., P.N.A.H.); Children's Health Queensland Hospital and Health Service, Brisbane, QLD, Australia (A.J.U., T.M.K., P.L.-A., V.G.); Griffith University, Brisbane, QLD, Australia (A.J.U., D.A., T.M.K., R.M.W., N.M., A.C.B., R.R., J.B., V.C., C.M.R., R.S.W.); Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia (A.J.U., T.M.K., N.M., K.S., A.C., P.N.A.H.); Princess Alexandra Hospital, Brisbane, QLD, Australia (R.M.W., B.P., N.R., J.L., C.B., P.M.); University of Colorado, Denver (V.C.); and Metro North Health, Brisbane, QLD, Australia (C.M.R.).
Background: New catheter materials for peripherally inserted central catheters (PICCs) may reduce the risk of device failure due to infectious, thrombotic, and catheter occlusion events. However, data from randomized trials comparing these catheters are lacking.
Methods: We conducted a randomized, controlled, superiority trial in three Australian tertiary hospitals.
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