Patients with bone marrow transplant may present with acute, life-threatening complications which frequently (40% of our cases) require intensive care unit treatment and result in an increased mortality (76% in this series). In an attempt to reach a more objective prognostic assessment, we have analyzed those factors related to the worst outcome in the 25 patients with bone marrow transplant admitted into our intensive care unit. Respiratory failure was the most frequent complication (72%), with an 83% mortality. Graft-versus-host disease and neutropenia led to a greater number of infectious complications with a poor outcome. Failure of more than three organ systems, septic shock and mechanical ventilation were statistically associated with mortality (p less than 0.05), and all patients who required mechanical ventilation for more than seven days or needed intensive therapy for more than 10 days died. The presence of septic shock, multisystem failure and severe neutropenia on admission should be considered as initial indicators of a poor prognosis. More than 7 days of mechanical ventilation and an intensive care unit stay of more than 10 days could be critical points in the reassessment of the intensity and prolongation of treatment.
Long-lasting, continuous and simultaneous EEG and ICP recordings from TBI and SAH patients provide highly rich and useful information, which has allowed for uncovering a strong relationship between both signals. The use of this relationship could lead to developing a medical device to measure ICP in a non-invasive way.
A 53 year old diabetic patient underwent CABG and aortic valve replacement in another institution and developed postoperative oliguric and hyperkalemic acute renal failure. Shortly after transferring to our unit a cardiac arrest occurred. Immediate resuscitative measures were ineffective. The serum potassium level was 10.2 mmol/l. Conventional arteriovenous hemodialysis was initiated while the patient was still undergoing cardiac massage. When the serum potassium level was lowered to 6.5 mmol/l, 90 min later, the heart began to beat. After hemodialysis was discontinued the patient was reactive and fully conscious. The use of simultaneous hemodialysis with prolonged mechanical heart massage as a reliable method for recovery in hyperkalemic cardiac standstill is stressed.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.