Several prevention and treatment strategies have been applied in order to prevent hypoxemia after open heart surgery with comparable good results. The aim of this study is to compare the effectiveness of two different alveolar recruitment maneuvers [RM] for the management of oxygenation impairment in cardiac surgical patients. A total number of sixty patients were included in this study. All patients underwent cardiac surgical procedures with extracorporeal circulation and developed oxygenation impairment after withdrawal of extracirculation support and sternal closure. Patients were randomly assigned into two Groups A and B according to the applied RM. In Group A three hyperinflations of the lungs were applied at an airway pressure of 40cmH2O for 10 sec, whereas in Group B Pressure Control Ventilation was applied for 2min with the inspiratory pressure set at 40cmH2O. After application of any of the two RM, PEEP was increased from 5 to 10 cmH2O in all patients. Anesthesia induction and maintenance and mechanical ventilation settings were similar in both study Groups. Continue reading
Pneumothorax is a collection of air in the pleural space between the lungs and the chest wall and depending on its cause it could be either spontaneous or traumatic. Tension Pneumothorax (TPT) can be a cause of cardiac arrest (CA) or might be a complication after chest compressions. According to the 2015 European Resuscitation Council guidelines on resuscitation, TP is considered one of the reversible causes of CA, which should be recognized and treated during cardiopulmonary resuscitation (CPR) Continue reading
Pericardial decompression syndrome (PDS) is a rare but eventually fatal syndrome, which occurs after pericardial drainage. In this report we describe a patient who suffered from cardiovascular collapse and pulmonary edema after pericardial drainage. A male patient aged 42yrs complained of progressive dyspnea over the past 2 months and presented with clinical signs of pericardial tamponade. The patient underwent a surgical subxiphoid pericardial drainage under general anesthesia and mechanical ventilation. After pericardial drainage of 2.2lt, the patient was transferred to the Intensive Care Unit, where he was extubated2 hours later. Immediately after extubation, he showed clinical signs of cardiovascular collapse and pulmonary edema. The patient was reintubated immediately and placed on mechanical ventilation. He was extubated after 12hrs. His postoperative course was uneventful and he was discharged from the hospital after a few days. Continue reading
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