Acute medicine & surgery
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Acute medicine & surgery · Jan 2020
Case ReportsFatal acute hypernatremia resulting from a massive intake of seasoning soy sauce.
Hypernatremia due to salt poisoning is clinically rare and standard care procedures have not been established. We report a case of salt poisoning due to massive intake of seasoning soy sauce. ⋯ After reviewing instances of resuscitation following salt intoxication, aggressive rapid correction of serum sodium concentration should only be considered in acute phases of hypernatremia within a few hours from ingestion, and 2-3 h could be one of the criteria.
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Acute medicine & surgery · Jan 2020
Influence of the COVID-19 pandemic on an emergency medical service system: a population-based, descriptive study in Osaka, Japan.
Novel coronavirus infection (COVID-19) was confirmed in Wuhan, China in December 2019, and the COVID-19 pandemic has spread around the world. However, no clinical studies on the impact of the COVID-19 pandemic on emergency medical service (EMS) systems have been carried out. ⋯ We assessed the impact of the COVID-19 pandemic on the EMS system in Osaka City, Japan and found that, since April 2020, the EMS system in Osaka City has been facing difficulty in terms of hospital acceptance of patients transported to hospital for acute diseases.
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Acute medicine & surgery · Jan 2020
Case ReportsVeno-venous extracorporeal membrane oxygenation and prone ventilation for therapeutic management of COVID-19.
The efficacy and safety of the combined use of veno-venous extracorporeal membrane oxygenation (ECMO) and prone ventilation are currently not known for coronavirus disease 2019 (COVID-19). ⋯ Oxygenation and lung compliance gradually improved during prone ventilation, and both patients were successfully extubated. For patients with severe SARS-CoV-2 pneumonia who require veno-venous ECMO, the use of prone ventilation could be beneficial, and should be considered.
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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
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.