Obstructive shock.

[Obstructive shock]. Anaesthesist. 2015 May 21; Authors: Pich H, Heller AR Abstract An acute obstruction of blood flow in central vessels of the systemic or pulmonary circulation causes the clinical symptoms of shock accompanied by disturbances of consciousness, centralization, oliguria, hypotension and tachycardia. In the case of an acute pulmonary embolism an intravascular occlusion results in an acute increase of the right ventricular afterload. In the case of a tension pneumothorax, an obstruction of the blood vessels supplying the heart is caused by an increase in extravascular pressure. From a hemodynamic viewpoint circulatory shock caused by obstruction is closely followed by cardiac deterioration; however, etiological and therapeutic options necessitate demarcation of cardiac from non-cardiac obstructive causes. The high dynamics of this potentially life-threatening condition is a hallmark of all types of obstructive shock. This requires an expeditious and purposeful diagnosis and a rapid and well-aimed therapy. PMID: 25994928 [PubMed - as supplied by publisher]
Source: Der Anaesthesist - Category: Anesthesiology Authors: Tags: Anaesthesist Source Type: research

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​Seventy-five percent of trauma injuries involve some kind of thoracic insult, a quarter of which need a procedural intervention like a chest tube. (Surg Clin North Am 2007;87[1]:95; http://bit.ly/2HaoX90.) Long-term illness, lung disease, and post-operative complications may cause pleural effusions or a pneumothorax, so treating these conditions quickly can significantly decrease patient morbidity and mortality. Other indications for chest tube placement include:Trauma: Pneumothorax, hemopneumothorax, or tension pneumothoraxLong-term illness: Pleural effusion (cancer, pneumonia)Infection: Empyema, purulent pleuriti...
Source: The Procedural Pause - Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
CONCLUSIONS In this case series, kyphoplasty performed on 4 or more vertebral levels was not found to increase risk to patient safety, and it might decrease unnecessary risks associated with multiple operations. Also, morbidity associated with leaving some fractures untreated because of an unfounded fear of increased risk of complications might be decreased by treating 4 or more levels in the same anesthetic session. PMID: 29372861 [PubMed - as supplied by publisher]
Source: Journal of Neurosurgery.Spine - Category: Neurosurgery Authors: Tags: J Neurosurg Spine Source Type: research
Vedran Premuzic, Lea Katalinic, Marijan Pasalic, Hrvoje JurinSaudi Journal of Anaesthesia 2018 12(1):118-120 Cardiac tamponade caused by perforation of the cardiac wall is a rare complication related to central venous catheter (CVC) placement. A 71-year-old female with a previous history of moderate aortic stenosis and kidney transplantation was admitted to hospital due to global heart failure and worsening of allograft function. Intensified hemodialysis was commenced through a CVC placed in the right subclavian vein. Chest radiography revealed catheter tip in the right atrium and no signs of pneumothorax. Thorough diagno...
Source: Saudi Journal of Anaesthesia - Category: Anesthesiology Authors: Source Type: research
IntroductionAdvanced life support (ALS) guidelines recommend ultrasound to identify reversible causes of cardiac arrest. Right ventricular (RV) dilatation during cardiac arrest is commonly interpreted as a sign of pulmonary embolism. The RV is thus a focus of clinical ultrasound examination. Importantly, in animal studies ventricular fibrillation and hypoxia results in RV dilatation. Tension pneumothorax (tPTX) is another reversible cause of cardiac arrest, however, the impact on RV diameter remains unknown. AimTo investigate RV diameter evaluated by ultrasound in cardiac arrest caused by tPTX or hypoxia. MethodsPigs were ...
Source: Acta Anaesthesiologica Scandinavica - Category: Anesthesiology Authors: Tags: Original Article Source Type: research
Conclusions Several perioperative factors can be identified that are associated with the development of PPCs. Patients having one or more of these conditions should be subjected to intensified postoperative pulmonary care.
Source: Journal of Cranio Maxillofacial Surgery - Category: ENT & OMF Source Type: research
Authors: Yin JH, Chuang YJ, Hu HH Abstract A 61-year-old man with critical aortic stenosis underwent aortic valve replacement. Mechanical ventilation was applied because of postoperative acute pulmonary edema accompanied by poor ventilation and poor oxygenation, and the patient was also recannulized to an extracorporeal membranous oxygenator. Bilateral pneumothorax was found 2 days later, and the right upper and left lower chest quadrants were drained with pigtail catheters. The patient did not regain consciousness 5 days after cessation of propofol. He remained in a deep coma; anisocoric pupils without light refle...
Source: Acta Neurologica Taiwanica - Category: Neurology Tags: Acta Neurol Taiwan Source Type: research
We report a case of a 34‐year‐old lady with past history of asthma and pulmonary tuberculosis, who presented 5 weeks pregnant with acute dyspnea. Her chest X‐ray showed left‐sided complete lung collapse and concomitant right‐sided pneumothorax. The pneumothorax was initially managed conservatively with a chest tube but due to its persistence despite suction, was subsequently changed to a PneumostatTM, with which she was later discharged. She had a normal echocardiography (ejection fraction [EF] 67%) at 5 weeks of gestation but developed pulmonary hypertension (EF 55%, pulmonary arterial pressure 40.7 mmHg)...
Source: Respirology Case Reports - Category: Respiratory Medicine Authors: Tags: Case Report Source Type: research
A patient with cirrhosis and hepatocellular carcinoma, on the waiting list for liver transplantation, presented with lung nodule during initial evaluation. A CT-guided core needle lung biopsy under general anaesthesia was performed. Pneumothorax (figure 1) and a large amount of gas within the left ventricle (figure 2) were identified during the procedure. Neurological focal signs (drowsiness, conjugate eye deviation and right hemiparesis) were observed in the anaesthesia-recovery period. A brain CT scan was immediately obtained, showing cerebral air embolism (figure 3). Initial resuscitation and hyperbaric oxygen therapy w...
Source: Thorax - Category: Respiratory Medicine Authors: Tags: Images in Thorax, Journalology, Screening (oncology), Venous thromboembolism, Pulmonary embolism, Transplantation, Ethics Chest clinic Source Type: research
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Source: Journal of Thoracic Oncology - Category: Cancer & Oncology Tags: Original Articles Source Type: research
Abstract Bedside critical care ultrasound has performance similar to traditional tests in diagnosing certain pathologies such as pleural effusion, pericardial effusion, pneumothorax, global cardiac dysfunction, and deep venous thrombosis. In this review article, we will provide an update of ultrasound’s performance in assessing other pathologies. Specifically, we will discuss the diagnostic performance of ultrasound in the diagnosis of pulmonary embolism, pulmonary edema, and alveolar collapse; in evaluating readiness for extubation; and in predicting fluid responsiveness. These topics were chosen for their ...
Source: Current Anesthesiology Reports - Category: Anesthesiology Source Type: research
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