In high altitudes, usually above 2500 m, travelers are faced with decreased partial pressure of oxygen along with decreased barometric pressure. High-altitude illness, a syndrome of acute mountain sickness, high-altitude cerebral edema and high-altitude pulmonary edema, occurs due to the hypobaric hypoxia when there is inadequate acclimatization.This review provides detailed information about pathophysiology, clinical features, prevention and treatment strategies for high-altitude illness according to the current literature.
ObjectivesOur primary goal is to investigate the hypothesis that in patients with a detectable ventricular wall motion (VWM) in cardiac ultrasonography (US) during cardiopulmonary resuscitation (CPR), survival rate is significantly more than in patients without VWM in US.Material and methodsIn our prospective, single center study, 129 adult cardiac arrest (CA) patients were enrolled. Cardiac US according to Focus Assessed Transthoracic Echo (FATE) protocol was performed before CPR. Presence of VWM was recorded on forms along with demographic data, initial rhythm, CA location, presence of return of spontaneous circulation (ROSC) and time until ROSC was obtained.Results129 patients were included. ROSC was obtained in 56/77 (72.7%) patients with VWM and 3/52 (5.8%) patients without VWM which is statistically significant (p > 0.001). Presence of VWM is 95% (95% CI: 0.95–0.99) sensitive and 70% (95% CI: 0.58–0.80) specific for ROSC. 43/77 (55.8%) patients with VWM and 1 (1.9%) of 52 patients without VWM survived to hospital admission which was statistically significant (p < 0.001). Presence of VWM was 100% (95% CI: 0.87–1.00) sensitive and 54% (95% CI: 0.43–0.64) specific for survival to hospital admission.ConclusionNo patient without VWM in US survived to hospital discharge. Only 3 had ROSC in emergency department and only 1 survived to hospital admission. This data suggests no patient without VWM before the onset of CPR survived to hospital discharge and this may be an indication to end resuscitative efforts early in these patients.
OBJECTIVE:
The aim of the present study was to determine the demographic, medical, and treatment characteristics of patients followed up with the diagnosis of carbon monoxide (CO) poisoning in emergency care and also to determine the relationship of these patients’ clinical process and outcome between carboxyhemoglobin (COHb), lactate, and troponin levels.
METHODS:
The present study was conducted retrospectively between 01/01/2013 and 01/01/2016 by examining 450 patients who were referred to the emergency service for CO poisoning. The ages; sexualities; manners of application; clinical findings; levels of blood COHb, lactate, and troponin; applied oxygen treatment method; and outcome of patients were evaluated. Data analysis was done by Shapiro–Wilk, Student’s t, Mann–Whitney U, and chi-square tests.
RESULTS:
A total of 450 patients were included in the study. The median age of the patients was 35 (interquartile range (IQR) 26.75–45.00) years. In the study where data are not homogeneously distributed, the median levels of COHb, lactate, and troponin were 11.80% (IQR 3–23), 1.60 (IQR 1.10–2.5) mmol/l, and 0.00 (IQR 0.000–0.003) ng/ml, respectively. The levels of lactate were detected to be statistically high in patients who had syncope and who received hyperbaric oxygen treatment (p<0.05). In addition, the levels of lactate and troponin were significantly higher in patients who were hospitalized (p<0.05).
CONCLUSION:
The levels of COHb, lactate, and troponin can provide an insight to the clinician about hospitalization and the type of treatment.
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