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Wyświetlanie 1-2 z 2
Tytuł:
Neurogenic pulmonary edema induced by subarachnoid hemorrhage; case report on diagnostic and therapeutic implications
Autorzy:
Weiss, Guenter
Meyer, Frank
Powiązania:
https://bibliotekanauki.pl/articles/1395592.pdf
Data publikacji:
2015-04-01
Wydawca:
Index Copernicus International
Tematy:
neurogenic pulmonary edema
subarachnoidal hemorrhage
catecholamine
Opis:
An exemplary rare case of neurogenic pulmonary edema induced by intracranial hemorrhage was reported including diagnostic and therapeutic implications as well as management recommendations. A 35-year old man who was treated first by a neurosurgical approach because of a subarachnoid hemorrhage (bore hole trepanation) and subsequently on a surgical intensive care unit because of severe postoperative hemodynamic, cardiocirculatory, and pulmonary disruptions. To monitor cardiopulmonary condition and treatment effects, a Swan-Ganz catheter was placed in the pulmonary artery, since after trepanation, a critical cardiopulmonary status developed during postoperative mechanical ventilation and catecholamine administration. This condition was indicated by neurogenic pulmonary edema detected by control chest X-ray film and high oxygen load in the inspiratory air required for sufficient arterial oxygenation. After use of high positive end-exspiratory pressure (PEEP) (initially directed against neurogenic lesion), adaptation of initial dobutamine doses, initiation of norepinephrine administration, and substitution of fluids, the patient's blood pressure finally rose sufficiently to sustain regular cerebral blood perfusion and achieve better arterial oxygenation. Thus, the patient‘s cardiopulmonary condition stabilized and temporary cardiac insufficiency could be overcome. Subsequently, it became possible to decrease PEEP according to requirements to prevent or limit cerebral edema and to diminish catecholamine doses.
Źródło:
Polish Journal of Surgery; 2015, 87, 4; 189-193
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Chylous complications of various severity and manifestations within diverse compartments in reconstructive vascular surgery #) #) The manuscript is dedicated to Prof. Dr. Z. Halloul
Autorzy:
Barth, Udo
Wasseroth, Klaus
Rahms, Volker
Albrecht, Roland
Meyer, Frank
Powiązania:
https://bibliotekanauki.pl/articles/1392647.pdf
Data publikacji:
2018
Wydawca:
Index Copernicus International
Tematy:
Vascular surgery
chylous complications
lymphatic edema
lymphocele
lymphatic fistula
chylothorax
chylascites / chylascos / chyloperitoneum
Opis:
Introduction: Chylous complications, which also occur in the profile of vascularsurgical interventions with considerable frequency, are challenging with regard to their adequate management. Aim & method: Short compact overview on epidemiological, classifying, symptomatic, diagnostics and therapeutic aspects of chylous complications in vascular surgery, based on •own clinical experiences, 
 •current selection of relevant scientific references, and 
 •representative case reports from clinical practice. Results (complex patient- & clinical finding-associated aspects): •Basic treatment of lymphedema / postreconstructive edema comprises a complex physical therapy to improve edematous swelling, which needs to be usually performed over years. •In case of lymphocele, a wait-and-see strategy can be initially pursued to observe spontaneous clinical course. If the lymphocele and its clinical complaints persist, puncture, placement of drainage or temporary instillation of doxycyclin or ethanol can be attempted. •In case of lymphatic fistula, vacuum-assisted closure dressing, radiation and selective ligation of lymphatic vessels after previous application of methylene blue dye can be used. •Chylascites and chylothorax should be primarily treated – as has been widely established in the meantime – with a consequently conservative approach initially comprising paracentesis / thoracocentesis, protein-enriched and low-fat diet containing middle-chain triglycerides (MCT) or total parenteral nutrition combined with the application of a somatostatin analogue (surgical approach as ultima ratio only aiming at ligation of the lesioned lymphatic vessel – if necessary, including preoperative consumption of cream). Summary: Chylous complications can be primarily treated with conservative measures, which should be exploited using a step-wise approach prior to surgical intervention as ultima ratio. Conclusion: The experienced vascular surgeon should be acquainted with a sufficient, finding-adapted management of chylous complications. This requires a well-experienced clinician and surgeon with great expertise regarding the interdisciplinary setting comprising of interventional radiology, vascular (abdominal) surgery and partially surgical intensive care.
Źródło:
Polish Journal of Surgery; 2018, 90, 3; 43-48
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
    Wyświetlanie 1-2 z 2

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