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https://www.readbyqxmd.com/read/28983829/mechanical-ventilation-during-resuscitation-how-manual-chest-compressions-affect-a-ventilator-s-function
#1
Tillmann Speer, Wolfgang Dersch, Björn Kleine, Christian Neuhaus, Clemens Kill
INTRODUCTION: Guidelines for resuscitation recommend positive-pressure ventilation with a fixed ventilation rate as provided by an automated transport ventilator during cardiopulmonary resuscitation (CPR) with a secured airway. We investigated the influence of manual chest compressions (CC) on the accuracy of ventilator presets and the quality of CC with intermittent positive-pressure ventilation (IPPV), bilevel ventilation (BiLevel), and the novel ventilation mode chest compression synchronized ventilation (CCSV) in a simulation model...
October 5, 2017: Advances in Therapy
https://www.readbyqxmd.com/read/28975363/decompression-of-tension-pneumothoraces-in-asian-trauma-patients-greater-success-with-lateral-approach-and-longer-catheter-lengths-based-on-computed-tomography-chest-wall-measurements
#2
S Goh, W R Xu, L T Teo
INTRODUCTION: Our study aims to compare the anterior and lateral approaches for needle thoracostomy (NT) and determine the adequacy of catheter lengths used for NT in Asian trauma patients based on computed tomography chest wall measurements. METHODOLOGY: A retrospective review of chest computed tomography scans of 583 Singaporean trauma patients during period of 2011-2015 was conducted. Four measurements of chest wall thickness (CWT) were taken at the second intercostal space, midclavicular line and fifth intercostal space, midaxillary line bilaterally...
October 3, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28963613/cardiothoracic-injuries-after-cardiopump-cpr-a-report-of-two-cases-and-review-of-the-literature
#3
Martin Kolopp, Angélique Franchi, Patrick Grafiadis, Laurent Martrille
Although many clinical trials have demonstrated its efficacy during active compression-decompression cardiopulmonary resuscitation (ACD-CPR), the Ambu® CardioPump seems likely to cause severe and sometimes lethal injuries. In this paper, we report two cases observed at the Institute of Legal Medicine of Nancy, France. A 67-year-old man collapsed in the street, in the presence of witnesses, and without any sign of trauma. The autopsy revealed a flail chest, a wound of the left ventricle, a rupture of the right ventricle, and a wrenching of the inferior vena cava...
September 29, 2017: International Journal of Legal Medicine
https://www.readbyqxmd.com/read/28900861/acute-kidney-injury-caused-by-decompression-illness-successfully-treated-with-hyperbaric-oxygen-therapy-and-temporary-dialysis
#4
Arata Hibi, Keisuke Kamiya, Takahisa Kasugai, Keisuke Kamiya, Satoru Kominato, Chiharu Ito, Toshiyuki Miura, Katsushi Koyama
A 52-year-old Japanese male professional diver was referred to our hospital for decompression illness (DCI). After 1 h of diving operation at 20 m below sea level, he complained of dyspnea, chest pain, and abdominal pain. He dove again, intending to ease the symptoms, but the symptoms were never relieved. He dove for a total of 4 h. No neurological abnormalities were observed. Computed tomography images revealed portal venous gas and mesenteric venous gas, in addition to bubbles in the femoral veins, pelvis, lumbar canal, intracranial sinuses, and joints...
September 12, 2017: CEN Case Reports
https://www.readbyqxmd.com/read/28885469/bigger-is-better-comparison-of-alternative-devices-for-tension-hemopneumothorax-and-pulseless-electrical-activity-in-a-yorkshire-swine-model
#5
Matthew L Leatherman, Laura M Fluke, Christian S McEvoy, Douglas M Pokorny, Robert L Ricca, Matthew J Martin, Christopher S Gamble, Travis M Polk
BACKGROUND: Tension pneumothorax is a cause of potentially preventable death in pre-hospital and battlefield settings and 14g angiocatheter (14G AC) decompression remains the current treatment standard, despite its high incidence of failure. Traumatic pneumothorax is often associated with hemothorax, but 14G AC has no proven efficacy for associated hemothorax. We sought to compare the 14G AC to three alternative devices for treatment of tension hemopneumothorax (t-H/PTX) in a positive pressure ventilation swine model...
September 5, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28840002/video-assisted-thoracoscopic-surgery-for-intrathoracic-first-rib-resection-in-thoracic-outlet-syndrome
#6
Jinwook Hwang, Byung-Ju Min, Won-Min Jo, Jae Seung Shin
BACKGROUND: First rib resection is a surgical treatment for decompressing the neurovascular structures in thoracic outlet syndrome (TOS). Historically, extrathoracic approaches have used a posterior, supraclavicular, or transaxillary incision to remove the first rib. In this report, we demonstrate video-assisted thoracoscopic surgery for intrathoracic first rib resection (VATS-IFRR). METHODS: Between 2009 and 2014, eight patients underwent VATS-IFRR for TOS. Surgery was performed through two 5-mm ports and one 10-mm port...
July 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28800887/evaluation-of-the-boussignac-cardiac-arrest-device-b-card-during-cardiopulmonary-resuscitation-in-an-animal-model
#7
Johanna C Moore, Lionel Lamhaut, Alice Hutin, Kenneth W Dodd, Aaron E Robinson, Michael C Lick, Bayert J Salverda, Mason B Hinke, José Labarere, Guillaume Debaty, Nicolas Segal
AIM OF THE STUDY: The purpose of this study was to examine continuous oxygen insufflation (COI) in a swine model of cardiac arrest. The primary hypothesis was COI during standard CPR (S-CPR) should result in higher intrathoracic pressure (ITP) during chest compression and lower ITP during decompression versus S-CPR alone. These changes with COI were hypothesized to improve hemodynamics. The second hypothesis was that changes in ITP with S-CPR+COI would result in superior hemodynamics compared with active compression decompression (ACD) + impedance threshold device (ITD) CPR, as this method primarily lowers ITP during chest decompression...
August 9, 2017: Resuscitation
https://www.readbyqxmd.com/read/28791071/periorbital-and-mediastinal-emphysema-after-upper-gastrointestinal-endoscopy-case-report-of-a-rare-complication
#8
Thankappan Lekha, Leelakrishnan Venkatakrishnan, Karuppannasamy Divya, Perumal Lavanya
PURPOSE: To report a rare case of periorbital emphysema concurrent with cervicofacial and mediastinal emphysema in an elderly woman who underwent upper gastrointestinal endoscopy for chronic liver disease. CASE REPORT: An elderly woman with decompensated chronic liver disease presented with features of periorbital, facial, and mediastinal emphysema, characterized with crepitant swelling over the right periorbital area, face, neck, and mediastinum after undergoing upper gastrointestinal endoscopy...
July 2017: Journal of Ophthalmic & Vision Research
https://www.readbyqxmd.com/read/28780253/biomechanics-of-human-parietal-pleura-in-uniaxial-extension
#9
Luis E Morales Tenorio, Kelsey J Devine, Jayme Lee, Timothy M Kowalewski, Victor H Barocas
Tension pneumothorax, a major preventable cause of battlefield death, often arises from chest trauma and is treated by needle decompression to release trapped air from the pleural cavity. Surgical simulation mannequins are often employed to train medical personnel to perform this procedure properly. Accurate reproduction of the mechanical behavior of the parietal pleura, especially in response to needle penetration, is essential to maximize the fidelity of these surgical simulators. To date, however, the design of pleura-simulating material has been largely empirical and based on subjective practitioner feel rather than on the tissue properties, which have remained unknown...
July 29, 2017: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/28770418/acute-vs-elective-paraesophageal-hernia-repair-endoscopic-gastric-decompression-allows-semi-elective-surgery-in-a-majority-of-acute-patients
#10
Andrea Wirsching, Moustapha A El Lakis, Kamran Mohiuddin, Agostino Pozzi, Michal Hubka, Donald E Low
BACKGROUND: Historically, patients presenting acutely with paraesophageal hernia and requiring urgent operation demonstrated inferior outcomes compared to patients undergoing elective repair. METHODS: A prospective IRB-approved database was used to retrospectively review 570 consecutive patients undergoing paraesophageal hernia repair between 2000 and 2016. RESULTS: Thirty-eight patients presented acutely (6.7%) and 532 electively. Acute presentation was associated with increased age (74 vs...
August 2, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28699426/management-of-hemothorax-after-thoracic-endovascular-aortic-repair-for-ruptured-aneurysms
#11
Mila H Ju, Michael J Nooromid, Heron E Rodriguez, Mark K Eskandari
Background Thoracic aortic aneurysm rupture is often a fatal condition. Emergent thoracic endovascular aortic repair (TEVAR) has emerged as a suitable treatment option. Unfortunately, respiratory complications from hemothorax continue to be an important cause of morbidity and mortality even after successful management of the aortic rupture. We hypothesize that early hemothorax decompression after TEVAR for ruptured aneurysms decreases the rate of postoperative respiratory complications. Methods Single-center, retrospective eight-year review of ruptured thoracic aneurysms treated with TEVAR...
January 1, 2017: Vascular
https://www.readbyqxmd.com/read/28657909/life-threatening-and-suspicious-lesions-caused-by-mechanical-cardiopulmonary-resuscitation
#12
Louise Milling, Peter Mygind Leth, Birgitte Schmidt Astrup
Chest compression devices for mechanical cardiopulmonary resuscitation (CPR) have become more common. Here, we report the case of a young woman who attempted resuscitated with LUCAS™2 after she was found unconscious at home. At autopsy, we found extensive intramuscular hemorrhages in posterior neck, between the scapulae, and in the lumbar region. Investigation of internal organs showed injuries to the lung, spleen, and kidney. The extension of the injuries gave rise to suspicion of homicide by smothering, which police investigation subsequently did not support...
September 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28637440/acute-airway-compromise-due-to-parathyroid-tumour-apoplexy-an-exceptionally-rare-and-potentially-life-threatening-presentation
#13
Aoife Garrahy, David Hogan, James Paul O'Neill, Amar Agha
BACKGROUND: Spontaneous haemorrhage into a parathyroid adenoma is a rare and potentially life-threatening presentation. CASE PRESENTATION: We report the case of a 45 year old female recently diagnosed with primary hyperparathyroidism who presented with chest discomfort and acute airway compromise due to spontaneous extracapsular haemorrhage into a parathyroid adenoma. Computed tomography (CT) imaging showed a hypopharyngeal haematoma extending 10 cm into the superior mediastinum...
June 21, 2017: BMC Endocrine Disorders
https://www.readbyqxmd.com/read/28632556/watertight-sealing-without-lumbar-drainage-for-incidental-ventral-dural-defect-in-transthoracic-spine-surgery-a-retrospective-review-of-53-cases
#14
Sang-Hyeop Jeon, Sang-Ho Lee, Yi Sheng Tsang, Tag-Geun Jung, Ki-Hyoung Moon, Gun Choi, Ketan D Dilip
STUDY DESIGN: A retrospective review. OBJECTIVES: To evaluate the therapeutic efficacy of the triple layer closure technique to establish watertight sealing without diversion of lumbar drainage, in preventing persistent incidental subarachnoid-pleural fistula and other neurological complications related to excessive drainage of cerebrospinal fluid (CSF) after dural defect in transthoracic ossified posterior longitudinal ligament (OPLL) surgery. SUMMARY OF BACKGROUND DATA: CSF leakage into the pleural cavity leads to unfavorable conditions for natural healing of incidental durotomy due to the negative pressure environment of the pleural space and lack of wound healing around the bony cavity near the decompressed spinal cord...
July 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28607783/intramural-hematoma-of-the-esophagus-complicating-severe-preeclampsia
#15
Simone Garzon, Giovanni Zanconato, Nicoletta Zatti, Giuseppe Chiarioni, Massimo Franchi
Intramural hematoma of the esophagus is a rare injury causing esophageal mucosal dissection. Forceful vomiting and coagulopathy are common underlying causes in the elderly population taking antiplatelets or anticoagulation agents. Acute retrosternal pain followed by hematemesis and dysphagia differentiates the hematoma from other cardiac or thoracic emergencies, including acute myocardial infarction or aortic dissection. Direct inspection by endoscopy is useful, but chest computed tomography best assesses the degree of obliteration of the lumen and excludes other differential diagnoses...
2017: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28602457/acute-idiopathic-gastric-distension-causing-atrioventricular-block-and-cardiogenic-shock
#16
Ryan Stringer, Megan Schrader
BACKGROUND: We report a rare case of acute idiopathic gastric dilatation with associated severe bradycardia and shock. CASE REPORT: A 69-year-old woman presented to the emergency department (ED) with complaint of chest pain and dyspnea. The patient required transvenous cardiac pacing for profound bradycardia and cardiogenic shock. After a negative emergent cardiac catheterization, a flat plate abdominal x-ray study demonstrated massive gastric dilatation, prompting nasogastric tube placement, with subsequent rapid improvement of the patient's cardiovascular and metabolic instability...
June 8, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28580205/solid-variant-of-an-aneurysmal-bone-cyst-of-the-thoracic-spine
#17
Varshil Mehta, Pravin Padalkar, Maya Kale, Ambadas Kathare
The solid variant of an aneurysmal bone cyst (ABC) has been observed very rarely, especially those involving the spine. In this case report, we present a very unusual tumour of the thoracic spine which was managed by 360˚ decompression via posterior-only approach and stabilization. A 16-year-old boy presented to us with a sudden onset of weakness in both lower limbs leading to paraplegia. He also had a history of back and chest pain over the past one year. A collapse of the T5 vertebrae on plain radiograph was observed...
May 1, 2017: Curēus
https://www.readbyqxmd.com/read/28536223/cardiac-compression-due-to-gastric-volvulus-an-unusual-cause-of-chest-pain
#18
Alex Brown, David Austin, Venkatesh Kanakala
A 42-year-old man was admitted to coronary care for assessment with severe retrosternal chest pain. Echocardiography showed significant external compression of the left atrium. A subsequent CT scan revealed him to have a large hiatus hernia, with most of his stomach herniating into his thorax causing left atrial compression and gastric volvulus. He subsequently underwent successful emergency decompression of the gastric volvulus and repair of his hiatus hernia.
May 22, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28461164/chest-compliance-is-altered-by-static-compression-and-decompression-as-revealed-by-changes-in-anteroposterior-chest-height-during-cpr-using-the-resqpump-in-a-human-cadaver-model
#19
Nicolas Segal, Aaron E Robinson, Paul S Berger, Michael C Lick, Johanna C Moore, Bayert J Salverda, Mason B Hinke, Andrew A Ashton, Angela M McArthur, Keith G Lurie, Anja K Metzger
INTRODUCTION: Chest compliance plays a fundamental role in the generation of circulation during cardiopulmonary resuscitation (CPR). To study potential changes in chest compliance over time, anterior posterior (AP) chest height measurements were performed on newly deceased (never frozen) human cadavers during CPR before and after 5min of automated CPR. We tested the hypothesis that after 5min of CPR chest compliance would be significantly increased. METHODS: Static compression (30, 40, and 50kg) and decompression forces (-10, -15kg) were applied with a manual ACD-CPR device (ResQPUMP, ZOLL) before and after 5min of automated CPR...
July 2017: Resuscitation
https://www.readbyqxmd.com/read/28458928/iatrogenic-right-sided-pneumothorax-presenting-as-st-segment-elevation-a-rare-case-report-and-review-of-literature
#20
Bashar Alzghoul, Ayoub Innabi, Anusha Shanbhag, Kshitij Chatterjee, Farah Amer, Nikihil Meena
Pneumothorax is a well-recognized complication of central venous line insertion (CVL). Rarely, pneumothorax can lead to electrocardiogram (ECG) findings mimicking ST-segment elevation myocardial infarction. We present a 63-year-old man with iatrogenic right-sided pneumothorax who developed ST-segment elevation on a 12-lead ECG suggestive of myocardial infarction. The ECG findings completely resolved after needle decompression and chest tube placement. This case points up this rare electrocardiographic finding with discussion of possible mechanisms and differential diagnosis...
2017: Case Reports in Critical Care
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