Pub Date : 1900-01-01DOI: 10.35841/ANESTHESIOLOGY.3.1.1-4
L. Ek
The management of severe ARDS (Adult respiratory distress syndrome) when maximal ventilator support fails has always been a challenge in places whereby Extracorporeal membrane oxygenation (ECMO) service may not be easily available or it may not be an option. Hypothermia therapy as a main mode of therapy for ARDS had been explored before but the result so far has not been convincing though Villar, had reported some success with hypothermic therapy for patients in 1993 but so far there have been a few recent trials that suggest otherwise. There are however a few case reports that had showed improvement in patients with severe ARDS refractory to other modes of conventional therapies. We would like to share the reports of 2 young males with severe ARDS from community and hospital acquired pneumonia with PaO2/ FiO2 ratio below 100 that was on maximal AC/VC ventilator support of FiO2 of 100% with sedation and muscle relaxants. These 2 patients received adjuvant hypothermia therapy for 24 hours before they were gradually rewarmed to 37°C and weaned off ventilator support over the next 2 weeks. They recovered fully from their pneumonia and were subsequently discharged from the hospital.
{"title":"Hypothermia therapy as an adjuvant therapy for severe ARDS","authors":"L. Ek","doi":"10.35841/ANESTHESIOLOGY.3.1.1-4","DOIUrl":"https://doi.org/10.35841/ANESTHESIOLOGY.3.1.1-4","url":null,"abstract":"The management of severe ARDS (Adult respiratory distress syndrome) when maximal ventilator support fails has always been a challenge in places whereby Extracorporeal membrane oxygenation (ECMO) service may not be easily available or it may not be an option. Hypothermia therapy as a main mode of therapy for ARDS had been explored before but the result so far has not been convincing though Villar, had reported some success with hypothermic therapy for patients in 1993 but so far there have been a few recent trials that suggest otherwise. There are however a few case reports that had showed improvement in patients with severe ARDS refractory to other modes of conventional therapies. We would like to share the reports of 2 young males with severe ARDS from community and hospital acquired pneumonia with PaO2/ FiO2 ratio below 100 that was on maximal AC/VC ventilator support of FiO2 of 100% with sedation and muscle relaxants. These 2 patients received adjuvant hypothermia therapy for 24 hours before they were gradually rewarmed to 37°C and weaned off ventilator support over the next 2 weeks. They recovered fully from their pneumonia and were subsequently discharged from the hospital.","PeriodicalId":190630,"journal":{"name":"Anesthesiology and Clinical Science Research","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126534641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.35841/ANESTHESIOLOGY.3.1.8-11
T. Ku
Traumatic brain injury (TBI) accounts for about 30-50% of all trauma-related deaths with a male predominance. It can be classified on the basis of neurological assessment using Glasgow Coma Score into, mild (13/15), moderate (9-12/15) and severe (3-8/15). Moderate to severe TBI often require admission to the Intensive care unit (ICU). Mnemonics have been found to be useful in remembering systematic management of clinical conditions especially for the young and inexperienced physician. This is an attempt to provide a useful mnemonic, “HEAD” for the management of TBI in the ICU.
创伤性脑损伤(TBI)约占所有创伤相关死亡的30-50%，以男性为主。根据格拉斯哥昏迷评分(Glasgow Coma Score)的神经学评估分为轻度(13/15)、中度(9-12/15)和重度(3-8/15)。中度至重度脑外伤通常需要入住重症监护病房(ICU)。人们发现，记忆法在记忆系统地管理临床状况方面非常有用，特别是对年轻和缺乏经验的医生而言。这是试图提供一个有用的助记符，“HEAD”在ICU的TBI管理。
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