Journal of intensive care medicine
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J Intensive Care Med · Sep 2014
Case ReportsFatal case of tension pneumothorax and subcutaneous emphysema after open surgical tracheostomy.
Tracheostomy tube placement remains one of the most commonly performed procedures in the intensive care unit. Its utilization permits ventilation in patients with severe compromise of the airway patency as well as facilitation of liberation of mechanical ventilation in patients with prolonged ventilatory needs. ⋯ We report a case of a surgical tracheostomy complicated with fatal tension pneumothorax and subcutaneous emphysema secondary to an iatrogenic posterior tracheal wall laceration. This complication is barely seen in usual practice, and its recognition and aggressive therapy may avoid fatal outcomes.
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J Intensive Care Med · Sep 2014
Review Case ReportsChiari syndrome and respiratory failure: a literature review.
Patients with failed extubation requiring reintubation have increased morbidity and mortality. This situation may reflect the severity of the underlying disorder or may reflect an undiagnosed condition that was not apparent at the time of the initial intubation. ⋯ Patients with CMs can have repeated extubation failures. Some of these patients have normal neurological examinations and studies and are not identified until they have an MRI study. Clinicians need to consider this possibility in patients who are difficult to wean.
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Intraabdominal infections are frequent and dangerous entity in intensive care units. Mortality and morbidity are high, causes are numerous, and treatment options are variable. ⋯ Current research describes a wide heterogeneity of patient populations, making it difficult to suggest a general treatment regimen and stressing the need of an individualized approach to decision making. Early focus-oriented intervention and antibiotic coverage tailored to the individual patient and hospital is warranted.
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J Intensive Care Med · Sep 2014
Critical care in patients undergoing lumbar spine fusion: a population-based study.
Data on the utilization of critical care services (CCSs) among patients who underwent spine fusion are rare. Given the increasing popularity of this procedure, information regarding demographics and risk factors for the use of these advanced services is needed in order to appropriately allocate resources, educate clinical staff, and identify targets for future research. ⋯ Approximately, 10% of the patients undergoing lumbar spine surgery require CCS. Utilizing the present data, critical care physicians and administrators can identify patients at risk, educate clinical staff, identify targets for intervention, and allocate resources to meet the needs of this particular patient population.
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J Intensive Care Med · Sep 2014
Case ReportsA patient with trauma having cavitary pulmonary nodules: should further workup be pursued?
Traumatic pulmonary pseudocysts (TPPs) are rare sequelae of blunt chest trauma and may be incidentally visualized on initial, or subsequent, chest imaging. ⋯ The TPPs may be discovered on imaging shortly after blunt chest trauma and, in asymptomatic individuals, can often be monitored with observation and serial imaging.