Southern medical journal
-
Southern medical journal · Jul 2005
Clinical TrialMeasurement of central venous pressure from a peripheral intravenous catheter in the lower extremity.
The measurement of central venous pressure (CVP) is used to assess intravascular status. Although this is usually accomplished by placement of a central venous catheter (CVC), there are circumstances when placement of a CVC may be technically difficult or impossible. The current study investigates the feasibility of measuring CVP from a peripheral intravenous catheter. ⋯ Provided that the PVP increases to a sustained inspiratory breath and occlusion above the intravenous site, there is a clinically useful correlation between the PVP and the CVP.
-
Southern medical journal · Jul 2005
Case ReportsCalciphylaxis: a rare association with alcoholic cirrhosis. Are deficiencies in protein C and S the cause?
Calciphylaxis is a rare condition of induced systemic hypersensitivity in which tissues respond to appropriate challenging agents with a sudden local calcification. It is characterized by acute calcium deposition in the medial layer of small and intermediate dermal vasculature that can lead to epidermal ischemia, ulceration, and necrosis. Calciphylaxis typically occurs in patients with end-stage renal disease who are undergoing dialysis and who have secondary hyperparathyroidism. ⋯ However, it has been suggested that deficiencies of protein C and protein S may play a role in the pathophysiology of this disorder. Our patient is the fourth with cirrhosis to be reported to have developed calciphylaxis and adds further evidence that low levels of these anticoagulant factors may be an important etiologic factor for development of calciphylaxis. This report should alert the clinician that calciphylaxis occurs in patients with cirrhosis and should stimulate further research concerning the possible role of protein C and protein S deficiency in calciphylaxis.