scholarly journals Rapid resolution of severe subcutaneous emphysema causing respiratory failure with subcutaneous drain

2021 ◽  
Vol 9 ◽  
pp. 2050313X2199719
Author(s):  
Ala Mustafa ◽  
Caio Heleno ◽  
Douglas T Summerfield
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Respiratory Failure ◽  
Respiratory Distress ◽  
Critically Ill ◽  
Subcutaneous Emphysema ◽  
Case Reports ◽  
Definitive Treatment ◽  
Critically Ill Patient ◽  
Rapid Resolution

This case reports on a critically ill patient (Male, 74) with severe subcutaneous emphysema which progressed to causing respiratory distress. We document both the severity of the condition we observed and then present a novel intervention. In this case, we decompressed the patient at the intensive care unit-bedside and resolved the condition. While subcutaneous emphysema is relatively common, the severity of the condition we observed, and the lack of definitive treatment guidance have prompted us to present this case as a plausible treatment guide.

scholarly journals Interrelated factors of tracheostomy in critically ill pediatric patients during their stay at ICU or PICU in Japan: a data-based analysis

2020 ◽  
Author(s):  
Tadashi Ishihara ◽  
Hiroshi Tanaka
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Respiratory Failure ◽  
Critically Ill ◽  
Chronic Conditions ◽  
Large Scale ◽  
Pediatric Patients ◽  
Upper Airway ◽  
Chromosomal Anomalies ◽  
Multicenter Cohort Study

Abstract Background The most common current indications of pediatric tracheostomy include prolonged ventilator dependence, often resulting from the consequences of prematurity and bronchopulmonary dysfunction, and upper airway obstruction resulting either from craniofacial or structural abnormalities of the upper airway or from hypotonia stemming from neurological or neuromuscular disturbance. The purpose of this study was to describe the indications, epidemiology, frequency, and associated factors for tracheostomy in critical pediatric patients admitted to the intensive care unit (ICU) or pediatric intensive care unit (PICU) by using the large amount of data available in the Japanese Registry of Pediatric Acute Care (JaRPAC). Methods In this retrospective multicenter cohort study, we collected data concerning pediatric tracheostomy from the JaRPAC database involving patients aged ≤ 16 years who had no tracheostomy when admitted to ICU or PICU between April 2014 and March 2017. The patients were divided into two groups: those with tracheostomies when they were discharged from the ICU or PICU and patients without tracheostomies. Interrelated factors of tracheostomy were investigated. Results A total of 23 hospitals participated, involving 6,199 pediatric patients registered in the JaRPAC database during the study period. Of the registered pediatric patients, 5,769 (95%) patients were admitted to the ICU or PICU without tracheostomies. Among the patients, 181 patients (3.1%) had undergone tracheostomies. There were significant differences in the number of chronic conditions (134, 74.0% versus 3096, 55.4%, p < 0.01), chromosomal anomalies (19, 10.5% versus 326, 5.8%, p < 0.01), urgent admission (151, 83.4% versus 3093, 55.4%, p < 0.01). More tracheostomies were performed on patients who were admitted for respiratory failure (61, 33.7% versus 926, 16.1%, p < 0.01) and for post-CPA resuscitation (40, 22.1% versus 71, 1.1%, p < 0.01). Conclusions This is the first report to use a large-scale registry of critically ill pediatric patients in Japan to describe the interrelated factors of tracheostomies during their stay in ICUs or PICUs. Chronic conditions (especially for neuromuscular disease), chromosomal anomaly, urgent admission, admission due to respiratory failure, or treatment for post-CPA resuscitation all had the possibility to be risk factors for tracheostomy.

Pleural Disease in the Intensive Care Unit

2000 ◽  
Vol 15 (2) ◽  
pp. 63-89
Author(s):  
Michael A. Jantz ◽  
Steven A. Sahn
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pleural Effusion ◽  
Critically Ill ◽  
Bronchopleural Fistula ◽  
Tension Pneumothorax ◽  
Respiratory Physiology ◽  
Critically Ill Patient ◽  
Pleural Disease ◽  
The Impact

Pleural disease itself is an unusual cause for admission to the intensive care unit (ICU). Pleural complications of diseases and procedures in the ICU are common, however, and the impact on respiratory physiology is additive to that of the underlying cardiopulmonary disease. Pleural effusion and pneumothorax may be overlooked in the critically ill patient due to alterations in radiologic appearance in the supine patient. The development of a pneumothorax in a patient in the ICU represents a potentially life-threatening situation. This article reviews the etiologies, pathophysiology, and management of pleural effusion, pneumothorax, tension pneumothorax, and bronchopleural fistula in the critically ill patient. In addition, we review the potential complications of thoracentesis and chest tube thoracostomy, including re-expansion pulmonary edema.

Cardiopulmonary support in the intensive care unit

1992 ◽  
Vol 1 (1) ◽  
pp. 98-106
Author(s):  
M Cone ◽  
M Hoffman ◽  
D Jessen ◽  
P Posa ◽  
C Dailey ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Tissue Perfusion ◽  
Definitive Treatment ◽  
Critically Ill Patient ◽  
Careful Monitoring ◽  
Cardiopulmonary Support ◽  
Critical Care Team ◽  
Adequate Tissue ◽  
Cardiopulmonary Support System

The cardiopulmonary support system is an extracorporeal device that allows for rapid cardiopulmonary support of the critically ill patient in the intensive care unit. It provides immediate and complete support of cardiac and pulmonary functions to maintain perfusion to vital organs in patients who are severely physiologically compromised (eg, in cardiogenic shock, adult respiratory distress syndrome or pulmonary edema). Successful cardiopulmonary support requires systemic anticoagulation, percutaneous venous and arterial cannulation and careful monitoring by the critical care team to maintain adequate tissue perfusion and oxygenation. Although patient mortality can occur secondary to bleeding, embolism or sepsis, this technique provides life-sustaining circulatory and respiratory support until definitive treatment can be initiated.

Bedside Thoracic Ultrasonography for the Critically Ill Patient: From the Emergency Department to the Intensive Care Unit

2020 ◽  
Vol 39 (3) ◽  
pp. 215-228
Author(s):  
María C. Arango-Granados ◽  
Luis A. Bustamante Cristancho ◽  
Virginia Zarama Córdoba
Keyword(s):  
Intensive Care Unit ◽  
Emergency Department ◽  
Intensive Care ◽  
Critically Ill ◽  
Critically Ill Patient

scholarly journals The psychological aspects of intensive care units

Curationis ◽  
1982 ◽  
Vol 5 (3) ◽  
Author(s):  
G. Dannenfeldt
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Critically Ill ◽  
Nursing Care ◽  
Psychological Problems ◽  
Psychological Aspects ◽  
Critically Ill Patient ◽  
Physical Care

The technical and physical care of the critically ill patient has been perfected, but the psychological aspects of intensive nursing care have to a greater or lesser extent been neglected. The objective of this article is to highlight the causes of psychological problems in an intensive care unit, how to recognise these problems and above all how to prevent or correct them.

scholarly journals Trans-diaphragmatic pressure measurement as a prognostic factor in the Intensive Care Unit in dogs

2020 ◽  
Vol 70 (4) ◽  
pp. 1851
Author(s):  
K. PAVLIDOU ◽  
I. SAVVAS
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Prognostic Factor ◽  
Critically Ill ◽  
Pressure Measurement ◽  
Lactate Concentration ◽  
Prognostic Indicators ◽  
Critically Ill Patient ◽  
Balloon Catheters ◽  
Detailed Assessment

In the last decade, attempts to improve the quality of the services provided to the critically ill patients in the Intensive Care Unit (ICU) are of great interest in human medicine. The aim of the majority of the clinical studies is the correlation of the survival rate of a critically ill patient with specific prognostic factors at the time of admission. The detailed assessment of a patient at admission in the ICU and during hospitalization seems to affect the management and the outcome. The main aim of this study was to evaluate if the trans-diaphragmatic pressure measurement can be a prognostic factor of the outcome in the ICU in dogs. Thirty-one dogs, 21 male and 10 female was included in this prospective, cohort study. Age, breed, sex, body weight and clinical diagnosis were recorded. The type of admission, the mentation status, physiological and biochemical parameters were measured at the admission of the dog in the ICU. All the variables were assessed over the first 24 hours following ICU admission. The animals were allocated into sixgroups: peritonitis/intra-abdominal surgery, intra-thoracic surgery, respiratory disease, neurologic disease, neoplasia, and systematic disease. The trans-diaphragmatic pressure (Pdi) was measured under the same anesthetic level in all animals with two oesophageal balloon catheters. The most frequent problem for admission in ICU was peritonitis (5/31). Seventeen out of 31 were admitted in acute status while 14/31 had a chronic problem. Mean±standard deviation of Pdi was 10.7±5.6 mmHg and of lactate concentration 2.3±1.2 mmol/L. Both, they can predict outcome (p=0.071 and p=0.076, respectively). Seven out of 31 dogs died, 2 were euthanized and 22 were discharged from the ICU after hospitalization. The technique of Pdi measurement with balloon catheters can be successfully applied in dogs in the ICU. Pdi measurement, as well as lactate concentration may be used as prognostic indicators for the outcome, in dogs in the ICU. However, a bigger sample size is need to support these findings.

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