Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Septic shock is associated with a mortality of 20-40%. The white blood cell count (WBC) at hospital admission correlates with prognosis in septic shock. Here, we explore whether the trajectory of WBC after admission provides further information about outcomes. We aimed to identify groups of patients with different WBC trajectories and the association of WBC trajectory with mortality. ⋯ In patients with septic shock, distinct and clinically relevant groups can be identified by analyzing WBC trajectories. A rising WBC trajectory was associated with higher mortality.
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Freon™ is a halogenated hydrocarbon often used as a refrigerant. When inhaled recreationally, it has the desired effects of euphoria and intoxication. Toxic effects include cardiovascular and neurologic insults such as arrhythmias and seizures, and less well-described toxicities include airway and lung injury. The treatment in general is primarily supportive. ⋯ To our knowledge, this is the first case report of an inhaled Freon exposure resulting in acute lung injury refractory to conventional therapy that was salvaged by vv-ECMO as a bridge towards a full recovery.
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Using machine learning, we developed a proprietary ultrasound software called the Spine Level Identification (SLIDE) system, which automatically identifies lumbar landmarks in real time as the operator slides the transducer over the lumber spine. Here, we assessed the agreement between SLIDE and manual palpation and traditional lumbar ultrasound (LUS) for determining the primary target L3-4 interspace. ⋯ gov (NCT02982317); registered 5 December 2016.
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No reports have described techniques to efficiently anesthetize the lateral cutaneous branches of the entire abdomen. The aim of this study was to investigate an effective procedure for blocking the lateral cutaneous branches in the abdominal region. We sought to describe the sensory distribution of the previously described thoracoabdominal nerve block through perichondrial approach (TAPA) and the novel costal and lateral external oblique muscle plane (EXOP) blocks in healthy volunteers. ⋯ The results of this pilot study in ten healthy volunteers indicate that novel EXOP blocks involving local anesthetic injection superficial to the external oblique muscle efficiently anesthetize the lateral cutaneous branches of the thoracoabdominal nerves. Our study shows that it may be anatomically plausible for the combined use of these blocks to anesthetize the entire abdominal wall.