Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine
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The management of trauma patients differs depending upon the healthcare system available. ⋯ Despite variation in pre-hospital transfer times and interventions, no significant difference was demonstrated in RTS upon arrival, or for the unadjusted mortality rates.
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Indian J Crit Care Med · Jan 2012
Structured approach to treat patients with acute liver failure: A hepatic emergency.
Acute liver failure (ALF) is a condition of acute hepatic emergency where rapid deterioration of hepatocyte function leads to hepatic encephalopathy, coagulopathy, cerebral edema (CE), infection and multi-organ dysfunction syndrome resulting in a high mortality rate. Urgent liver transplantation is the standard of care for most of these patients in Western countries. However, in India, access to liver transplantation is severely limited and, hence, the management is largely based on intensive medical care. ⋯ The current review highlights the important medical management issues in patients with ALF in general as well as the management of major complications associated with ALF. We performed a MEDLINE search using combinations of the key words such as acute liver failure, intensive treatment of acute liver failure and fulminant hepatic failure. We reviewed the relevant publications with regard to intensive care of patients with ALF.
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Indian J Crit Care Med · Jan 2012
Asystole during pulmonary artery catheter insertion under general anesthesia.
In spite of ongoing debate for the past 40 years, pulmonary artery catheters remain in use for invasive hemodynamic monitoring and management of critically ill patients. We describe a case of a sudden onset of asystolic cardiac arrest during the placement of a pulmonary artery catheter, while under general anesthesia. A brief review of the literature highlighting arrhythmic complications associated with pulmonary artery catheterization is also presented.
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Indian J Crit Care Med · Jan 2012
An unusual case of nonocclusive mesenteric ischemia in a young girl.
Nonocclusive mesenteric ischemia is a type of acute mesenteric ischemia with high mortality seen mostly in elderly cardiac patients. We present a 21-year-old healthy student with nonocclusive mesenteric ischemia along with radiological evidence of hepatic portal venous gas and pneumatosis intestinalis, with subsequent fatality. Its significance and its possible etiology are discussed.