Acute medicine & surgery
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Acute medicine & surgery · Jan 2020
Case ReportsVeno-venous extracorporeal membrane oxygenation for severe pneumonia: COVID-19 case in Japan.
Veno-venous extracorporeal membrane oxygenation (VV-ECMO) is one of the ultimate treatments for acute respiratory failure. However, the effectiveness of ECMO in patients with novel coronavirus disease (COVID-19) is unknown. ⋯ Treatment of severe pneumonia in COVID-19 by ECMO should recognize lung plasticity considering time to ECMO introduction and interstitial biomarkers. In Japan, centralization of ECMO patients has not been sufficient. Thus, we suggest nationwide centralization and further research to respond to the crisis caused by COVID-19.
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Acute medicine & surgery · Jan 2020
Prediction of the neurological outcome using regional cerebral oxygen saturation in patients with extracorporeal cardiopulmonary resuscitation after out-of-hospital cardiac arrest: a multicenter retrospective cohort study.
To investigate the association between regional cerebral oxygen saturation (rSO2) and neurological outcomes in extracorporeal cardiopulmonary resuscitation (ECPR) patients after out-of-hospital cardiac arrest (OHCA). ⋯ The neurological outcome of ECPR patients differed according to their rSO2 values. When considering ECPR, the rSO2 value could be important in addition to other criteria. Further studies that focus on ECPR patients and serial rSO2 values are needed.
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Acute medicine & surgery · Jan 2020
Case ReportsLate-onset ornithine transcarbamylase deficiency: a rare cause of recurrent abnormal behavior in adults.
Ornithine transcarbamylase is an enzyme of the urea cycle, which produces urea from ammonia. Although ornithine transcarbamylase deficiency mainly occurs as a severe neonatal-onset disease, a late-onset form that could become symptomatic from infancy to adulthood is also known. ⋯ Awareness of adult onset ornithine transcarbamylase deficiency in a patient with acute psychiatric symptoms due to hyperammonemia is important.
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Acute medicine & surgery · Jan 2020
Case ReportsSuccessful treatment with artificial pancreas for a patient who attempted suicide using a high-dose insulin s.c. injection.
Artificial pancreas is usually used to manage hyperglycemia. We controlled prolonged hypoglycemia induced by insulin overdose using artificial pancreas. ⋯ The STG-55 artificial pancreas was very useful and convenient for controlling blood glucose levels in our insulin overdose patient.
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Acute medicine & surgery · Jan 2020
Comparison of high-flow nasal cannula oxygen therapy and non-invasive ventilation as first-line therapy in respiratory failure: a multicenter retrospective study.
To identify which subgroups of respiratory failure could benefit more from high-flow nasal cannula oxygen therapy (HFNC) or non-invasive ventilation (NIV). ⋯ High-flow nasal cannula oxygen therapy could be more beneficial than NIV in patients with pneumonia or non-hypercapnia, but not in patients with cardiogenic pulmonary edema or hypercapnia.