CASE REPORT OF DIGITAL NECROSIS DUE TO RADIAL ARTERY INJURY AND AN ASSOCIATION WITH THE ARTERIAL ANATOMY OF THE HAND

Radial artery puncture, an invasive procedure, is frequently used in critically-ill patients. Although considered safe, severe and rare complications such as finger necrosis can occur. Here we report a case of finger necrosis and discuss its relationship with the anatomy of hand arteries

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Case Report: COVID-19 Pneumonia Following Left Pneumonectomy for Lung Cancer Complicated by Empyema and Bronchopleural Fistula

Frontiers in Surgery ◽

10.3389/fsurg.2021.679757 ◽

2021 ◽

Vol 8 ◽

Author(s):

Alberto Testori ◽

Veronica M. Giudici ◽

Marco Alloisio ◽

Ugo Cioffi

Keyword(s):

Lung Cancer ◽

Case Report ◽

Critically Ill ◽

Critically Ill Patients ◽

Statistical Data ◽

Pulmonary Thromboembolism ◽

Bronchopleural Fistula ◽

Case Presentation ◽

Arterial Thromboembolism ◽

Left Pneumonectomy

Background: Venous and arterial thromboembolism is commonly reported in critically ill COVID-19 patients, although there are still no definitive statistical data regarding its incidence.Case presentation: we report a case of a patient who fell ill with Covid during hospitalization for a pneumonectomy complicated by empyema and bronchopleural fistula. The patient, despite being cured of COVID, died after 14 days for pulmonary thromboembolism.Conclusion: Our case strengthens the suggestion of adequate thromboprophylaxis in all hospitalized COVID patients and of increasing prophylaxis in critically ill patients even in the absence of randomized studies

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Case report: inspiratory muscle training in chronic critically ill patients — A report of two cases

Physiotherapy Research International ◽

10.1002/pri.14 ◽

2005 ◽

Vol 10 (4) ◽

pp. 222-226 ◽

Cited By ~ 14

Author(s):

Angela T Chang ◽

Robert J Boots ◽

Robert Henderson ◽

Jennifer D Paratz ◽

Paul W Hodges

Keyword(s):

Case Report ◽

Critically Ill ◽

Critically Ill Patients ◽

Inspiratory Muscle ◽

Inspiratory Muscle Training ◽

Muscle Training

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A New Noninvasive Method to Measure Blood Pressure

Anesthesiology ◽

10.1097/00000542-199909000-00021 ◽

1999 ◽

Vol 91 (3) ◽

pp. 686-686 ◽

Cited By ~ 84

Author(s):

Kumar Belani ◽

Makoto Ozaki ◽

James Hynson ◽

Thomas Hartmann ◽

Hugo Reyford ◽

...

Keyword(s):

Blood Pressure ◽

Critically Ill ◽

Radial Artery ◽

Pulse Rate ◽

Critically Ill Patients ◽

Arterial Catheter ◽

Arterial Waveform ◽

Measure Blood Pressure ◽

The Mean ◽

Radial Artery Catheter

Background Blood pressure (BP) monitoring with arterial waveform display requires an arterial cannula. We evaluated a new noninvasive device, Vasotrac (Medwave, Arden Hills, MN) that provides BP measurements approximately every 12-15 beats and displays pulse rate and a calibrated arterial waveform for each BP measurement. Methods Surgical and critically ill patients (n = 80) served as subjects for the study. BPs, pulse waveforms, and pulse rates measured via a radial artery catheter were compared with those obtained by the Vasotrac from the opposite radial artery. Data were analyzed to determine agreement between the two systems of measurement. Results Blood pressure measured noninvasively by the Vasotrac demonstrated excellent correlation (P<0.01) with BP measured via a radial arterial catheter (systolic r2 = 0.93; diastolic r2 = 0.89; mean r2 = 0.95). Differences in BP measured by the Vasotrac versus the radial arterial catheter were small. The mean+/-SD bias and precision were as follows: systolic BP 0.02+/-5.4 mm Hg and 3.9+/-3.7 mm Hg; diastolic BP -0.39+/-3.9 mm Hg and 2.7+/-2.8 mm Hg; mean BP -0.21+/-3.0 mm Hg and 2.1+/-2.2 mm Hg compared with radial artery measurements. The Vasotrac pulse rates were almost identical to those measured directly (r2 = 0.95). The Vasotrac BP waveform resembled those directly obtained radial artery pulsatile waveforms. Conclusions In surgical and critically ill patients, the Vasotrac measured BP, pulse rate, and displayed radial artery waveform, which was similar to direct radial arterial measurements. It should be a suitable device to measure BP frequently in a noninvasive fashion.

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Radial artery catheterization of critically ill patients in the emergency department

Annals of Emergency Medicine ◽

10.1016/s0196-0644(89)80741-3 ◽

1989 ◽

Vol 18 (4) ◽

pp. 463

Author(s):

GF Bachhuber ◽

DW Plummer ◽

M Lutze ◽

E Ruiz

Keyword(s):

Emergency Department ◽

Critically Ill ◽

Radial Artery ◽

Critically Ill Patients ◽

Radial Artery Catheterization

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Blood product therapy in the ICU

10.1093/med/9780199600830.003.0267 ◽

2016 ◽

Author(s):

Lirong Qu ◽

Darrell J. Triulzi

Keyword(s):

Critically Ill ◽

Critically Ill Patients ◽

Large Body ◽

Invasive Procedure ◽

Transfusion Practice ◽

Transmission Risk ◽

Haemostatic Agents ◽

Circulatory Overload ◽

Red Cell Transfusion ◽

Transfusion Guidelines

Transfusions are among the most common medical procedures in the intensive care unit. Several randomized controlled trials (RCT) indicate that restrictive red cell transfusion practice using a haemoglobin of <7g/dL is safe in critically-ill patients. Although similar RCT are not available for plasma or platelet transfusion guidelines, a large body of observational studies suggest that plasma transfusion for an invasive procedure has not been shown to be of benefit in patients with INR <2.0. Similarly, in thrombocytopenic patients, the target platelet count for bleeding or for an invasive procedure is 50,000/µl. Viral transmission risk has become exceedingly low. Other risks such as transfusion-associated circulatory overload and, to a lesser extent, transfusion-related acute lung injury, are much more common. Storage of red cells does not seem to be associated with adverse clinical outcomes. Alternatives using haemostatic agents, salvaged blood, and adherence to evidence-based transfusion guidelines probably reduce the need for transfusion in critically-ill patients.

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Very-low-dose ketamine for the management of pain and sedation in the ICU

Journal of Opioid Management ◽

10.5055/jom.2008.0009 ◽

2018 ◽

Vol 4 (1) ◽

pp. 54 ◽

Cited By ~ 20

Author(s):

Mario De Pinto, MD ◽

Jill Jelacic, MD ◽

William T. Edwards, PhD, MD

Keyword(s):

Mechanical Ventilation ◽

Case Report ◽

Respiratory Depression ◽

Critically Ill ◽

Critically Ill Patients ◽

Low Dose ◽

Anesthetic Agent ◽

Cardiovascular Instability ◽

High Doses ◽

Very High

Management of pain in critically ill patients can be very difficult. In the attempt to provide comfort with adequate levels of opioids and sedatives, respiratory depression and cardiovascular instability may become difficult to control in patients with labile hemodynamics and poor cardiopulmonary reserve. The use of medications like ketamine, an anesthetic agent that in subanesthetic doses has been reported to be effective in preventing opioidinduced tolerance and to have analgesic properties, may be of help, especially in patients who develop tolerance, leading to rapidly escalating doses of opioids and sedatives. The case report presented here shows how a very low dose of ketamine can be helpful for the management of pain and sedation in critically ill patients, especially when they are ready to be weaned from mechanical ventilation, and very high doses of opiods and sedatives do not permit it.

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