Duodenal Perforation Caused Septic Shock: a Rare Case Combined With Coronavirus Disease 2019

2020 ◽  
Author(s):  
Huanhuan Guo ◽  
Jing Hu ◽  
Yunxiang Li ◽  
Wei Xiang ◽  
Quan Gan
Keyword(s):  
Septic Shock ◽  
Medical Intensive Care Unit ◽  
Duodenal Perforation ◽  
Emergency Laparotomy ◽  
Case Presentation ◽  
Risk Pregnancy ◽  
Multidisciplinary Cooperation ◽  
Epidemic Period ◽  
Medical Intensive Care ◽  
Novel Coronavirus

Abstract Background: Duodenal perforation is one of the rarer causes of acute abdomen in pregnancy, which is especially easy to be overlooked during the outbreak of 2019 novel coronavirus (2019-nCoV) after delivery.Case presentation: Here, we report a case of duodenal perforation-induced septic shock with coronavirus disease 2019 (COVID-19), and the patient underwent emergency laparotomy after reporting to the hospital management department under strict protection. Her recovery in postoperative period in Medical Intensive Care Unit (MICU) was uneventful and she was transferred to a designated hospital for treatment of COVID-19 5 days later.Conclusions: The establishment of emergency green channel for maternal health care, and timely and comprehensive multidisciplinary cooperation during the epidemic period, strengthen the standardized management of high-risk pregnancy, and better guarantee the safety of mothers and infants.

scholarly journals Mortality-associated factors in old patients with severe sepsis or septic shock in the medical intensive care unit

Critical Care ◽  
2007 ◽  
Vol 11 (Suppl 3) ◽  
pp. P29
Author(s):  
R Bak ◽  
CS Salomão ◽  
RL Machado ◽  
GMM Oliveira ◽  
EB Lameu ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Septic Shock ◽  
Severe Sepsis ◽  
Intensive Care ◽  
Associated Factors ◽  
Medical Intensive Care Unit ◽  
Old Patients ◽  
Medical Intensive Care

scholarly journals Perihepatic Abscess due to a Liver Suture with Pledgets Used to Treat a Penetrating Liver Injury

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Hazuki Koguchi ◽  
Kimihiko Kusashio ◽  
Akihiro Fujita ◽  
Nao Yamamoto
Keyword(s):  
Liver Injury ◽  
Good Condition ◽  
Bile Leakage ◽  
Purulent Discharge ◽  
Duodenal Perforation ◽  
Emergency Laparotomy ◽  
Case Presentation ◽  
The Past ◽  
Liver Injuries ◽  
Selective Nonoperative Management

Background. Selective nonoperative management has become the standard for liver injuries. Accordingly, we cannot perform surgery for liver injuries as frequently as in the past. This report is aimed at sharing a valuable experience of postoperative complications after surgery for a liver injury. Case Presentation. A 40-year-old man was stabbed in his abdomen and underwent an emergency laparotomy for a severe liver injury. Five months after the operation, he developed fever, and purulent discharge was observed from an abdominal fistula. He was diagnosed with a perihepatic abscess and duodenal perforation due to the pledgets used for the operation. He underwent a second surgery to remove the pledgets and the abscess cavity for infection control and was discharged in good condition. Conclusion. The intra-abdominal environment should be considered contaminated due to bile leakage in surgeries following liver injury. Furthermore, nonabsorbable agents should not be used in these contaminated areas.

scholarly journals Sepsis and septic shock – an observational study of the incidence, management, and mortality predictors in a medical intensive care unit

2020 ◽  
Vol 61 (5) ◽  
pp. 429-439
Author(s):  
Vesna Vucelić ◽  
Iva Klobučar ◽  
Branka Đuras-Cuculić ◽  
Ana Gverić Grginić ◽  
Carmen Prohaska-Potočnik ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Septic Shock ◽  
Intensive Care ◽  
Observational Study ◽  
Medical Intensive Care Unit ◽  
Medical Intensive Care ◽  
Sepsis And Septic Shock ◽  
Mortality Predictors

Efficacy and Outcomes After Vasopressin Guideline Implementation in Septic Shock

2016 ◽  
Vol 51 (1) ◽  
pp. 13-20 ◽  
Author(s):  
Janet Y. Wu ◽  
Joanna L. Stollings ◽  
Arthur P. Wheeler ◽  
Matthew W. Semler ◽  
Todd W. Rice
Keyword(s):  
Septic Shock ◽  
Medical Intensive Care Unit ◽  
Medical Center ◽  
Guideline Implementation ◽  
Univariate Analysis ◽  
Multivariable Analysis ◽  
Severity Of Illness ◽  
Medical Intensive Care ◽  
Vanderbilt University ◽  
Goal Map

Background: In septic shock, the dose of norepinephrine (NE) at which vasopressin (AVP) should be added is unknown. Following an increase in AVP price, our medical intensive care unit (MICU) revised its vasopressor guidelines to reserve AVP for patients requiring greater than 50 µg/min of NE. Objective: The purpose of this study is to compare efficacy and safety outcomes for patients admitted before the guideline revision with those for patients admitted after the revision. Methods: This was a single-center, retrospective cohort study of patients admitted to Vanderbilt University Medical Center from November 1, 2014, to November 30, 2015. Before June 1, 2015, the vasopressor guidelines recommended initiation of AVP for patients requiring 10 µg/min of NE or greater. After June 1, 2015, the guidelines recommended initiation of AVP at a NE dose of 50 µg/min or greater. Results: Time to achieve goal mean arterial pressure (MAP) was shorter in the postintervention group (2.0 vs 1.3 hours; P = 0.03) in univariate analysis but not after adjusting for prespecified confounders. Incidence of new arrhythmias was similar between the 2 groups (14.9% vs 10.9%; P = 0.567). In multivariable analysis accounting for baseline severity of illness, admission after the revision was associated with decreased 28-day mortality (odds ratio = 0.34; 95% CI = 0.16-0.71; P = 0.004). Conclusions: Use of a vasopressor guideline restricting AVP initiation in septic patients to those on at least 50 µg/min of NE appeared to be safe and did not affect the time to reach goal MAP.

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