Internal and emergency medicine
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Deep vein thrombosis of upper limb is a common complication of CVC in patients with cancer. In these patients the risk factors for CVC-related thrombosis are not completely defined. The purpose of this study was to identify the risk factors for CVC-related thrombosis in patients included in a randomized, double-blind, placebo-controlled study aimed at assessing the efficacy and safety of enoxaparin for the prophylaxis of CVC-related thrombosis. ⋯ In addition to these risk factors, the presence of distant metastases (OR 9.36, 95%CI 1.53-57.05) increased the risk of thrombosis in patients who received placebo. An inadequate position of the CVC tip, left-sided CVC insertion and chest radiotherapy are independent risk factors for CVC-related thrombosis in cancer patients. Patients with distant metastases have an increased risk for thrombosis in absence of antithrombotic prophylaxis.
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Direct laryngoscopy for airway management was introduced into clinical medicine almost 70 years ago and is still the dominant modality. The recent development of video and optical laryngoscopy could be the most important change in this paradigm. This paper examines state of the art devices and makes recommendations regarding specific advantages they advance for the field of emergency medicine.