Rev Port Pneumol
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To determine the possibility of non-invasive estimation of central venous pressure (CVP) through inferior vena cava (IVC) analysis, using transthoracic echocardiography (TTE). ⋯ IVC analysis is a possible way to non-invasively estimate CVP in a medical /surgical ICU. However, patients with right ventricular enlargement and admitted with chronic respiratory failure present a lack of agreement between IVC parameters and low values of CVP. IVC dimension is a marker of chronic disease and IVC index correlated better with CVP.
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Dysthanasia or any of its synonyms is a consequence of excessive technical science, without any reasonable chance of achieving a therapeutic benefit for the patient. Medical futility is a distressing ethical dilemma of intensive care medicine. ⋯ Not withdrawing or withholding mechanical ventilation in certain circumstances can be considered as a paradigmatic model of medical futility. The understanding of this posture implies a philosophical approach and reflexion of medical practice.
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Case Reports
[Iatrogenic tracheal rupture: a case report and indications for conservative management].
Tracheal rupture after endotracheal intubation requires immediate intervention. There have been an increasing number of reports that describe nonsurgical management of this issue. We report the case of a 47-year-old woman who experienced an iatrogenic tracheal rupture during endotracheal intubation for a surgical procedure with general anaesthesia. ⋯ We review available literature on conservative management of tracheal rupture. Immediate recognition and adequate treatment are very important in managing this potentially fatal situation. The final decision should be based on clinical, radiologic and bronchoscopic findings.