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Zhang YL, Yang Z, Cao J, Bai YL, Fang CY, Wang W. Clinical Implications of the Lung Ultrasound Score in Patients after Cardiopulmonary Resuscitation. Emerg Med Int 2023; 2023:4951950. [PMID: 38170023 PMCID: PMC10761217 DOI: 10.1155/2023/4951950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 11/12/2023] [Accepted: 12/07/2023] [Indexed: 01/05/2024] Open
Abstract
Background Lung ultrasound score (LUS) is a clinical index used to measure lung injury, but its clinical value in patients after cardiopulmonary resuscitation (CPR) remains relatively unknown. The purpose of this study was to investigate the clinical value of LUS in patients after CPR. Methods This retrospective study included a total of 34 patients older than 18 years with a nontraumatic cause of in-hospital cardiac arrest, who received standard resuscitation and achieved return of spontaneous circulation (ROSC). All patients underwent bedside lung ultrasound examination within half an hour once ROSC was achieved, and LUSs were calculated. The study included patient death as the endpoint event. Results Compared with the group with lower LUSs, the patients with higher LUSs had a lower oxygenation index, longer duration of CPR, and lower 72 h survival rate. The initial LUS had good clinical value in predicting the secondary outcomes of CPR (adjusted odds ratio (aOR): 1.353, 95% confidence interval (CI): 1.018-1.797, and P = 0.037) and 72 h survival rate of patients who underwent CPR (aOR: 1.145, 95% CI: 1.014-1.294, and P = 0.029). Conclusions LUS was shown to be helpful and had a prognostic value in patients after CPR.
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Affiliation(s)
- Yi-Ling Zhang
- Department of Emergency, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Zhou Yang
- Department of Emergency, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Jie Cao
- Department of Emergency, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Yu-Long Bai
- Department of Emergency, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Chun-Yun Fang
- Department of Emergency, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Wei Wang
- Department of Emergency, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
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Han Q, Wang B, Xu A. Use of intraoperative ultrasonography for identification and management of pneumothorax caused by iatrogenic diaphragm defect: a case report and literature review. J Int Med Res 2020; 48:300060519898048. [PMID: 31964200 PMCID: PMC7113711 DOI: 10.1177/0300060519898048] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Transthoracic ultrasound has been widely accepted for the evaluation of many thoracic diseases, including pleural effusion, atelectasis, pneumothorax, and pneumonia with subpleural effusion. Application of ultrasonography for the diagnosis of pneumothorax is an effective and timely intraoperative technique. We herein present a patient who developed pneumothorax following diaphragmatic injury during laparoscopic cholecystectomy. The pneumothorax was rapidly identified by bedside ultrasound. The compressed lung was successfully re-expanded using positive end-expiratory pressure (PEEP) ventilation under real-time ultrasound monitoring, and closed thoracic drainage was avoided. Therefore, the correct use of ultrasound can identify the adequate PEEP level that is able to promote resolution of pneumothorax induced by diaphragmatic injury.
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Affiliation(s)
- Qiang Han
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Beibei Wang
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Aijun Xu
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
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Chao WT, Jiang LY, Chen GY, Wang PH, Wu HH, Chen YJ. Right postoperative pleural effusion and pulmonary embolism following laparoscopic gynecological surgery: A rare case report and PRISMA-driven systematic review. J Chin Med Assoc 2019; 82:957-961. [PMID: 31135576 DOI: 10.1097/jcma.0000000000000125] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The incidence of postlaparoscopic pleural effusion and pulmonary embolism were rare. However, it might be life-threatening. Therefore, confirming the risk factor and management is important. We present a 53-year-old woman with ovarian endometriosis arranged for laparoscopic surgery. However, desaturation was noted on postoperation day 1. Chest radiograph and chest computed tomography showed pleural effusion and pulmonary embolism. Pleural pigtail insertion was performed and anticoagulant medication, albumin, and lasix were given. The patient's recovery was uneventful. Several factors have been advanced to explain including the prolonged duration of the operation. Management options include supplemental oxygen therapy, and pigtail catheter insertion. Mechanical prophylaxis (sequential compression devices and graduated compression stockings) is sufficient for venous thromboembolism prevention.
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Affiliation(s)
- Wei-Ting Chao
- Faculty of Medicine, College of Medicine, Fu-Jen Catholic University, Taipei, Taiwan, ROC
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
- Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Ling-Yu Jiang
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
- Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Guan-Yeu Chen
- Faculty of Medicine, College of Medicine, Fu-Jen Catholic University, Taipei, Taiwan, ROC
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
- Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Peng-Hui Wang
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
- Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
- Department of Medical Research, China Medical University Hospital, Taichung, Taiwan, ROC
| | - Hua-Hsi Wu
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
- Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Yi-Jen Chen
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
- Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
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Laparoscopic Single Figure of Eight Suturing Omentopexy for the Treatment of a Perforated Duodenal Ulcer. THE JOURNAL OF MINIMALLY INVASIVE SURGERY 2019; 22:23-28. [PMID: 35601707 PMCID: PMC8979847 DOI: 10.7602/jmis.2019.22.1.23] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 07/26/2018] [Accepted: 08/01/2018] [Indexed: 11/18/2022]
Abstract
Purpose Safe and effective surgical treatment of peptic ulcer perforations is fundamental to achieve favorable outcomes. We present laparoscopic single figure of eight suturing omentopexy for perforated duodenal ulcer and review associated clinical outcomes. This is a new formulaic surgical technique for laparoscopic omentopexy. Methods Laparoscopic single figure of eight suturing omentopexies for perforated duodenal ulcer were completed in 15 consecutive patients between April 2008 and November 2017 at Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea. Using prospectively collected data, we performed an observational study on an intention-to-treat basis. Results The mean age of the 15 patients who underwent laparoscopic repair was 41.7±13.9 years. The perforation site was the anterior duodenal bulb in all patients. The median perforation size was 5 mm (range: 3~8 mm). The mean operation time was 66.7±19.6 minutes. There was no evidence of leakage from the omentopexy site clinically or in the postoperative upper gastrointestinal series. One patient (6.7%) experienced the postoperative complication of pneumothorax. There were no cases of postoperative mortality or reoperation within 30 days after surgery. The median time to tolerance of regular diet was 6 (range: 4~9) days. The median postoperative hospital stay was 7 days (range: 5~11 days). Conclusion Laparoscopic single figure of eight suturing omentopexy can be a viable option in the surgical management of perforated duodenal ulcer in selected patients without surgical risk factors. Laparoscopic single figure of eight suturing omentopexy is safe and easy to perform, and may therefore reduce operation time.
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Lai MF, Lin YC, Wu ZF. Tension pneumothorax caused by iatrogenic intra-abdominal explosion during laparoscopic procedure. J Clin Anesth 2019; 55:72-73. [PMID: 30597456 DOI: 10.1016/j.jclinane.2018.12.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 12/15/2018] [Accepted: 12/18/2018] [Indexed: 10/27/2022]
Affiliation(s)
- Meng-Fu Lai
- Department of Anesthesiology, Tri-Service General Hospital and National Defense Medical Center, No.325, Section 2, Chenggung Road, Neihu District, Taipei 11490, Taiwan, ROC
| | - Yi-Chin Lin
- Department of Anesthesiology, Tri-Service General Hospital and National Defense Medical Center, No.325, Section 2, Chenggung Road, Neihu District, Taipei 11490, Taiwan, ROC; Division of Anesthesiology, Taichung Armed Forces General Hospital, No.348, Section 2, Chungshan Road, Taiping District, Taichung City 41152, Taiwan, ROC
| | - Zhi-Fu Wu
- Department of Anesthesiology, Tri-Service General Hospital and National Defense Medical Center, No.325, Section 2, Chenggung Road, Neihu District, Taipei 11490, Taiwan, ROC.
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