Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia
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Ann Thorac Cardiovasc Surg · Feb 2006
Can the outcome of pediatric extracorporeal membrane oxygenation after cardiac surgery be predicted?
The purpose of this study is to assess whether clinical and biochemical variables may be used to predict outcome in children treated with extracorporeal membrane oxygenation (ECMO) after cardiac surgery and to determine when to discontinue ECMO support. ⋯ Our findings suggest patients who develop renal failure, stroke and DIC during ECMO support have a high mortality. Patients with single ventricle physiology, and repaired truncus arteriosus may benefit less from ECMO support and have an increased risk of death. Elevated levels of lactate during the first 72 hours, high inotrope score at the initiation of ECMO and long ECMO support duration (more than 3 days) are all potential variables that can be used in determining when to discontinue ECMO support.
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Ann Thorac Cardiovasc Surg · Feb 2006
Case ReportsLobar torsion after pulmonary resection; report of two cases.
Lobar torsion is a rare complication after pulmonary resection. We report a case of right middle lobe torsion following a right upper lobectomy, and left lower lobe torsion following a left upper lobectomy. ⋯ Both patients underwent re-thoracotomy; a middle lobectomy and completion pneumonectomy were performed. In the clinical management of lobar torsion urgent diagnosis and conclusive surgical resection is needed to avoid mortality and morbidity.
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Ann Thorac Cardiovasc Surg · Feb 2006
Case ReportsCoexistent lung carcinoma and active pulmonary tuberculosis in the same lobe.
We observed a rare case of lung carcinoma accompanied by active pulmonary tuberculosis in the same lobe. The chest x-ray of a 49-year-old man revealed an abnormal shadow in the right upper field and a giant bulla in the left upper field. Chest computed tomography (CT) revealed a nodule with consolidation, which was not continuous in the right S3. ⋯ Lymphadenectomy of the right hilum and mediastum was also performed. Microscopy revealed epidermoid carcinoma in the proximal tumor (pT3N0M0-stage IIB) and epithelioid granuloma with caseous necrosis, granulomatous pneumonia, exudative lesions, and fibrocaseous nodules in the distal lung. After surgery, anti-tuberculosis treatment was resumed.