scholarly journals Rapid popliteal artery release sensu A.N. Kazantsev in acute thrombosis in patients with COVID-19

2021 ◽  
Vol 26 (5) ◽  
pp. 4413
Author(s):  
A. N. Kazantsev ◽  
K. P. Chernykh ◽  
G. Sh. Bagdavadze ◽  
N. E. Zarkua ◽  
E. Yu. Kalinin ◽  
...  
Keyword(s):  
Multiple Organ Failure ◽  
Organ Failure ◽  
Popliteal Artery ◽  
Multiple Organ ◽  
Fatty Tissue ◽  
Rapid Release ◽  
Release Technique ◽  
Release Group ◽  
Group 2 ◽  
Group 1

Aim. To analyze the outcomes of popliteal thrombectomy using the standard release technique with vascular instruments and rapid release sensu A. N. Kazantsev in patients with acute popliteal artery thrombosis (PAT) and coronavirus disease 2019 (COVID-19).Material and methods. The present prospective single-center study for the period from April 1, 2020 to March 17, 2021 included 157 patients with acute PAT and COVID-19 at the Alexandrovskaya City Hospital. All patients were divided into 2 groups depending on the popliteal artery access: group 1 (n=88; 56%) — rapid release sensu A. N. Kazantsev; group 2 (n=69; 44%) — standard popliteal artery release using vascular instruments (vascular forceps and scissors) and tourniquets. Rapid popliteal artery release was distinguished by the fact that fasciotomy and hemostasis, the fatty tissue behind it and up to the artery was torn with two index fingers. First, the fingers were joined together at the lateral edges and inserted into the wound middle. Then the wound together with tissues was stretched with fingers to proximal and distal edges until the popliteal artery was visualized. Further, a Beckmann retractor was used to fix the torn fiber to the upper and lower wound walls. The tourniquets were not used.Results. Surgical access duration (group 1, 4,5±1,3 minutes; group 2, 11,41±0,9 minutes; p=0,005), as well as the total procedure duration (group 1, 47,5±2,8 minutes; group 2, 62,15±4,5 min; p=0,001) had the lowest values in the group of rapid popliteal artery release. Moreover, all intraoperative bleedings (n=11; 15,9%) was recorded in group 2 as a result of popliteal vein injuries and/or bleeding from popliteal artery. The retrombosis rate in the rapid release group was lower (group 1, 40,9%; group 2, 55,1%; p=0,03). On the first day after surgery, 18% of thrombosis developed in group 1, and 39% in group 2. The mortality rate was highest in the standard artery release group (group 1, 55,7%; group 2, 86,9%; p<0,0001; OR, 0,18; 95% CI, 0,08-0,42). In all cases, the cause of death was systemic multiple organ failure due to severe pneumonia, pulmonary edema, and cytokine storm.Conclusion. The use of rapid popliteal artery release sensu A. N. Kazantsev significantly reduces the thrombectomy duration in the context of COVID-19. This effect is achieved due to a decrease in the incidence of intraoperative bleeding, no need to use tourniquets and vascular instruments. A decrease in the ischemia duration using novel release technique reduces the retrombosis rate, as well as deaths caused by systemic multiple organ failure against the background of hyperperfusion and compartment syndrome. Reducing the operation duration with the use of rapid popliteal artery release sensu A. N. Kazantsev reduces the time of intraoperative mechanical ventilation, which in COVID-19 patients reduces the risks of pneumothorax, pneumomediastinum, emphysema, and pulmonary embolism. Thus, the rapid popliteal artery release sensu A. N. Kazantsev can be recommended for popliteal thrombectomy in patients with COVID-19.

scholarly journals Improving the therapy of generalized forms of Meningococcal infection in children using extracorporeal hemocorrection

2021 ◽  
Vol 20 (2) ◽  
pp. 49-56
Author(s):  
K. V. Markova ◽  
E. Yu. Skripchenko ◽  
K. V. Serednyakov ◽  
Yu. V. Lobzin ◽  
N. V. Skripchenko ◽  
...  
Keyword(s):  
Septic Shock ◽  
Multiple Organ Failure ◽  
Organ Failure ◽  
Multiple Organ ◽  
Meningococcal Infection ◽  
Basic Drug ◽  
Inflammatory Reactions ◽  
Clinical Center ◽  
Refractory Septic Shock ◽  
Group 2

Invasive meningococcal infection is a significant cause of death, reaching 80% in septic shock. The Pediatric Research and Clinical Center for Infectious Diseases (PRCCID) has developed an algorithm for the treatment of children with invasive meningococcal infection with refractory septic shock and multiple organ failure syndrome, which includes basic drug therapy with polymyxin hemoperfusion in combination with extended methods of extracorporeal hemocorrection.Purpose: to evaluate the effectiveness of extracorporeal hemocorrection operations in children with invasive meningococcal infection with refractory septic shock and multiple organ failure syndrome.Materials and research methods: to the intensive care unit of the PRCCID for the analyzed period 2006—2020 34 children were hospitalized with invasive meningococcal infection with refractory septic shock and multiple organ failure syndrome. Two groups were formed: Group 1 — children admitted to the PRCCID in the period 2014—2020 (n = 23), who underwent polymyxin hemoperfusion simultaneously with extended methods of extracorporeal hemocorrection, group 2 — children hospitalized in 2006—201 3 (n = 1 1), methods of extracorporeal hemocorrection were not performed. The Mann-Whitney U-test and ANOVA were used to evaluate the results.Results and discussion: the use of extracorporeal hemocorrection operations in the complex therapy of invasive forms of meningococcal infection with refractory septic shock and multiple organ failure syndrome in children provides stabilization of central hemodynamics, reduces clinical and laboratory inflammatory reactions, helps to reduce the dose of vasopressor drugs and parameters of respiratory support, and also increases patient survival rate by 82.6%.

Clinical case of periostitis in pregnant women complicated by sepsis

2020 ◽  
pp. 61-63
Author(s):  
S. Sh. Kakvaeva ◽  
M. A. Magomedova ◽  
A. N. Dzhalilova
Keyword(s):  
Pregnant Woman ◽  
Multiple Organ Failure ◽  
Pregnant Women ◽  
Organ Failure ◽  
Clinical Case ◽  
Clinical Observation ◽  
Infectious Agent ◽  
Modern Medicine ◽  
Multiple Organ ◽  
Number Of Patients

One of the most serious problems of modern medicine is sepsis. The number of patients undergoing this complication is 20–30 million (WHO) annually and has no tendency to decrease. Sepsis is characterized by severe multiple organ failure due to a violation of the response of the macroorganism to an infectious agent. Moreover, it is dangerous with high mortality. Sepsis often develops in patients with immunodeficiency conditions, which primarily include pregnant women. The article presents a clinical observation of a case of periostitis in a pregnant woman complicated by a septic state.

scholarly journals High-dose diquat poisoning: a case report

2021 ◽  
Vol 49 (6) ◽  
pp. 030006052110261
Author(s):  
Yanxia Huang ◽  
Renjing Zhang ◽  
Mei Meng ◽  
Dechang Chen ◽  
Yunxin Deng
Keyword(s):  
Renal Failure ◽  
Multiple Organ Failure ◽  
Organ Failure ◽  
Multiple Organ ◽  
High Dose ◽  
Severe Respiratory Failure ◽  
Aggressive Treatment ◽  
Lung Lesions ◽  
Pulmonary Lesions ◽  
New Treatment

Diquat is a widely used herbicide that is substituted for paraquat. With paraquat off the market, cases of diquat poisoning have been gradually increasing. The kidney is the most frequently impaired organ in diquat poisoning. Few cases of multiple organ failure caused by diquat have been reported. We herein describe a 30-year-old man who orally ingested about 160 mL of enriched diquat. Despite aggressive treatment, the patient’s condition progressed to multiple organ failure and death. The pulmonary lesions in this patient were different from those previously reported. This patient did not die of renal failure but of severe respiratory failure. He exhibited three different stages of pulmonary disease. The lung lesions in this case were unique. We hope that doctors will pay more attention to the lung lesions in patients with diquat poisoning in future and find new treatment methods to save the lives of such patients.

Endovascular treatment of an ilio-iliac arteriovenous fistula accompanied by venous thromboembolism presenting with multiple organ failure – A case report and literature review

Vascular ◽  
2021 ◽  
pp. 170853812199657
Author(s):  
Tiehao Wang ◽  
Jichun Zhao ◽  
Ding Yuan
Keyword(s):  
Multiple Organ Failure ◽  
Arteriovenous Fistula ◽  
Organ Failure ◽  
Iliac Artery ◽  
Vena Cava ◽  
Artery Aneurysm ◽  
Multiple Organ ◽  
High Rate ◽  
Type Ii ◽  
Type Ii Endoleak

Objectives Multiple organ failure is a rare manifestation of ilio-iliac arteriovenous fistula which can lead to a high rate of misdiagnosis and death. Methods We reported a 61-year-old man presenting with multiple organ failure rapidly after right lower limb swelling. Computed tomography angiography showed an ilio-iliac arteriovenous fistula caused by right common iliac artery aneurysm, and venous thrombosis of bilateral common iliac veins. A bifurcated stent-graft with coil embolization of right internal iliac artery was used for repair. Results The patient recovered rapidly and was discharged without complications. Although arteriovenous fistula persisted due to type II endoleak, aneurysm sac and inferior vena cava significantly shrunk at six months follow-up. Conclusions This report demonstrated that multiple organ failure may appear when the distal outflow tracts of arteriovenous fistula are obstructed. Moreover, endovascular repair is effective for reversal of multiple organ failure caused by arteriovenous fistula, even if arteriovenous fistula persists due to type II endoleak.

scholarly journals Post-COVID-19 Kawasaki-Like Syndrome

2021 ◽  
pp. 014556132110060
Author(s):  
Jérôme R. Lechien ◽  
Rémi Hervochon ◽  
Stéphane Hans
Keyword(s):  
Abdominal Pain ◽  
Multiple Organ Failure ◽  
Organ Failure ◽  
Hepatitis A ◽  
Clinical Presentation ◽  
Multiple Organ ◽  
Mild Form ◽  
Severe Dysphagia ◽  
History Of ◽  
Inflammatory Syndrome

A 42-year-old man was referred for a week history of severe dysphagia, odynophagia, fever (39 °C), fatigue, abdominal pain, pharyngeal swelling, and multiple neck lymphadenopathies. The medical history reported a mild form of COVID-19 one month ago. The biology reported an unspecified inflammatory syndrome. The patient developed peritonitis, myocarditis, and hepatitis. A myocardium biopsy was performed. A diagnosis of Kawasaki-like disease (KLD) was performed. The occurrence of KLD in adults is rare but has to be known by otolaryngologists regarding the otolaryngological clinical presentation that may precede the multiple organ failure.

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