The Journal of international medical research
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Review Case Reports
Septic shock after liver transplantation successfully treated with endotoxin and cytokine adsorption continuous renal replacement therapy: a case report and literature review.
Endotoxins and cytokines play an important role in multiple organ failure pathogenesis in patients with severe Gram-negative bacterial infection. We present a clinical case where an oXiris hemofilter was used for continuous renal replacement therapy (CRRT) treatment in a patient with septic shock after liver transplantation. A 35-year-old man with a 20-year history of hepatitis B presented with jaundice, loss of appetite, and decreased urine output. ⋯ Procalcitonin, endotoxin, and the inflammatory factors interleukin (IL)-6 and IL-10 also decreased gradually. The patient's liver and kidney functions were completely restored. Our experience suggests that oXiris CRRT combined with antibacterial therapy is an effective treatment for septic shock after liver transplantation.
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Review Case Reports
Hypocalcemic cardiomyopathy after parathyroidectomy in a patient with uremia: A case report and literature review.
Hypocalcemia is a rare, but reversible, cause of dilated cardiomyopathy. Although cardiomyopathy may cause severe heart failure, calcium supplementation can reverse heart failure. We report here a patient with uremia and secondary hyperparathyroidism, who was complicated by persistent hypocalcemia and refractory heart failure. ⋯ To the best of our knowledge, this is the first case of this disease to be reported in a patient with uremia. Findings from our case may help clinicians to better understand hypocalcemic cardiomyopathy. Our case might also provide new insight into long-term cardiac complications and prognoses of patients undergoing parathyroidectomy due to secondary hyperparathyroidism.
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Airway management under anesthesia is given special attention in patients who have large goiters. Nasogastric tube insertion may be difficult in intubated patients with large goiters. Several methods have been proposed to facilitate the insertion of nasogastric tubes in patients with endotracheal intubation; however, a standard insertion method has not been established. ⋯ Finally, the nasogastric tube was gently inserted via anterior displacement of the cricoid cartilage. The nasogastric tube advanced up to 60 cm. Surgery was performed, and the patient was discharged with no complications on postoperative day 8.
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In this survey, we assessed the current clinical management of postoperative delirium (POD) among Chinese anesthesiologists, after publishing the European POD guideline. ⋯ Our survey showed that there are high awareness levels among Chinese anesthesiologists regarding the importance of POD. However, routine assessment and monitoring of all patients, including perioperative anesthesia depth monitoring, and a treatment algorithm need to be implemented on a larger scale. According to the results, efforts should be made to improve the knowledge of POD among Chinese anesthesiologists.
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To compare the treatment outcome of venovenous extracorporeal membrane oxygenation (VV-ECMO) versus mechanical ventilation in hypoxemic patients with acute respiratory distress syndrome (ARDS) at a referral center that started offering VV-EMCO support in 2010. ⋯ Although VV-ECMO promoted lower-TV ventilation, it did not improve the in-hospital mortality rate. Trial registration: www.clinicaltrials.gov (NCT04031794).