Revista médica de Chile
-
Revista médica de Chile · Sep 2011
Review Case Reports[Venous thrombosis secondary to catheter insertion for hypothermia after cardiac arrest. Report of one case].
To improve survival and reduce neurological injury, the use of mild hypothermia following cardiac arrest has been recommended. We report a 65 years old woman who presented an out-of-hospital ventricular fibrillation and cardiac arrest. ⋯ Although no neurological impairment was observed, physical examination of the right inguinal area and echo-Doppler examination revealed an extensive catheter-related thrombophlebitis with right ileocaval vein occlusion., with high risk of massive and life threatening pulmonary embolism. We report a clinical case and review the literature to point out the need for a high index of diagnostic suspicion of deep venous thrombosis in these specific setting.
-
Terminally ill patients frequently have difficulties with fluid and food intake. The indication of artificial hydration in these patients has been subject of intense debate in the past years and the clinical practice widely varies, mostly based on anecdotal data and not on clinical evidence about risks and benefits associated to artificial hydration in terminal patients. ⋯ Several topics, such as the effect of artificial hydration alleviating symptoms or reversing neurological alterations as delirium, its life prolonging effect or if it promotes unnecessary suffering, are discussed. In this review we will analyze clinical benefits and risks associated to artificial hydration in terminal patients, making reference to some ethical principles involved.
-
Revista médica de Chile · Sep 2011
Randomized Controlled Trial[Transesophageal echocardiography to monitor fluid administration during the perioperative period].
During the perioperative period an adequate intravascular volume must be maintained. Current recommendations overestimate perioperative volume requirements. ⋯ The use of transesophageal echocardiography significantly reduced the perioperative fluid administration.
-
A virtual model of fibro-bronchoscopy is reported. The virtual model represents in 3D the trachea and the bronchi creating a virtual world of the bronchial tree. ⋯ The parameters of the virtual model were gradually adjusted according to expert opinion and allowed the training of specialists with a virtual bronchoscope of great realism. The virtual bronchial tree provides clues of reality regarding the movement of the bronchoscope, creating the illusion that the virtual instrument is behaving as the real one with all the benefits in costs that this means.
-
Revista médica de Chile · Sep 2011
Case Reports[Sub capsular splenic hematoma in a sickle cell trait carrier. Case report].
Drepanocytic anemia is an uncommon hereditary disease in Chile. The heterozygous state of drepanocytic anemia or "sickle trait" has a frequency of 8% among Afro-Americans. A small number of patients carrying hemoglobin S are homozygous, with clinical manifestations of hemolytic anemia and thrombotic disease. ⋯ Six days later, an angio CAT scan showed the presence of a subcapsular splenic hematoma that was managed conservatively. Sickle cell induction with sodium metabisulphite was positive. Hemoglobin electrophoresis confirmed the sickle trait.