Acta clinica Croatica
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Acta clinica Croatica · Apr 2023
COMPARISON OF LAPAROSCOPIC AND OPEN PYELOPLASTY IMPACT ON COMFORT AND SUCCESS: A RETROSPECTIVE, SINGLE CENTER STUDY.
Ureteropelvic junction obstruction causes hydronephrosis and may lead to renal parenchymal damage unless timely diagnosed and treated. Although open pyeloplasty is still the gold standard, it needs to be compared with new techniques. In this study, we compared laparoscopic and open pyeloplasty. ⋯ When compared to open pyeloplasty (mean 9.8 dexketoprofen 50 mg IV dose), the need for an analgesic was significantly lower in the laparoscopic pyeloplasty (mean 4.5, paracetamol 15 mg/kg IV dose) group (p<0.05). The length of hospital stay was also shorter in the laparoscopic pyeloplasty group (mean 4.0 days) than in the open pyeloplasty group (mean 7.3 days) (p<0.05). This study demonstrated that laparoscopic pyeloplasty could be safely used in the treatment of ureteropelvic junction obstruction with a lower need for analgesics and a shorter length of hospital stay than with open pyeloplasty.
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Acta clinica Croatica · Apr 2023
EPIDEMIOLOGICAL CHARACTERISTICS AND FACTORS ASSOCIATED WITH MORTALITY IN SEVERELY BURNED PATIENTS - CROATIAN NATIONAL BURN CENTER REPORT.
The authors conducted a single-center retrospective study during the last 6.5 years. The study aimed to describe demographic data of burn patients in the Croatian Burn Center and investigate factors affecting mortality for the first time after the Center was established. The study included 109 severely burned patients with a total body surface area (TBSA) burned ≥20%, admitted to the burn intensive care unit. ⋯ With an increase of TBSA by 1%, the odds of lethal outcome are expected to increase by 7% (p<0.0001). Other variables included in the analysis did not show statistical significance. TBSA percentage is a well-known predictor of mortality and numerous studies indicate an association between comorbidities and mortality but there are conflicting results about other demographic factors and injury characteristics.
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Acta clinica Croatica · Apr 2023
Case ReportsCOMBINED USE OF VIDEOLARYNGOSCOPE AND BONFILS INTUBATION ENDOSCOPE AS RESCUE OPTION FOR DIFFICULT AIRWAY MANAGEMENT: A CASE REPORT.
Difficult airway management poses a great challenge for clinicians, especially if it is unanticipated. Numerous guidelines and a wide array of devices constitute the anesthesiologist's armamentarium for managing the airway. When the use of individual devices fails, the use of combination techniques is advised. ⋯ While the videolaryngoscope provided the space needed for BIE and visual guidance through copious secretions, the BIE served as a stylet for endotracheal tube guidance, leading to successful intubation. Since the technique requires costly equipment, experience in handling it and at least two operators, it is more appropriate as a rescue measure than an elective procedure. Given the potentially disastrous outcomes of failed intubation, mastering advanced airway management techniques remains of vital importance, and the combination technique is one of them.
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Acta clinica Croatica · Apr 2023
Case ReportsWHOLE RANGE OF RESPIRATORY SUPPORT IN A PREGNANT WOMAN WITH A SEVERE FORM OF COVID-19 INFECTION: A CASE REPORT.
Acute respiratory syndrome caused by a novel coronavirus (SARS-CoV-2) in pregnant women can progress to a critical condition. In this paper, we present a case of a woman in the 28th week of gestation hospitalized due to respiratory insufficiency caused by COVID-19 infection and consequent bilateral pneumonia with development of severe acute respiratory distress syndrome. Noninvasive ventilation through a face mask was started but due to progression of respiratory insufficiency with high FiO2 and positive end expiratory pressure (PEEP), we decided to intubate the patient, after which obstetricians agreed to complete pregnancy by cesarean section. ⋯ Due to inadequate mechanical ventilation, the patient was transferred to Dr. Fran Mihaljević University Hospital for Infectious Diseases in order to perform extracorporeal membrane oxygenation (ECMO). Owing to all of the measures taken, recovery followed after 13 days on ECMO.
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Acta clinica Croatica · Apr 2023
COMPARISON OF C-REACTIVE PROTEIN LEVELS IN SERUM AND PERITONEAL FLUID IN EARLY DIAGNOSIS OF ANASTOMOTIC LEAKAGE AFTER COLORECTAL SURGERY.
In colorectal surgery, anastomotic leakage is a serious complication, leading to higher postoperative morbidity and mortality. The aim of this study was to evaluate the accuracy of serum and intraperitoneal C-reactive protein (CRP) in early diagnostics of anastomotic leakage on the first four postoperative days after colorectal surgery. ⋯ Comparing the levels of serum and intraperitoneal CRP, our study showed that serum CRP was a better predictor of anastomotic leakage. Serum CRP levels lower than 121 mg/L on postoperative day 4 were predictive of good healing of anastomosis.