Since the publication by F. Vourc'h in 1963 [Br J Anaesth (1963) 35:118-120] describing the use of a plastic catheter inserted percutaneously for the drainage of lumbar cerebrospinal fluid (CSF) the indications for spinal drainage are numerous, but not very well systematized. The bibliographical review shows few recent papers concerning the techniques, indications, complications and pitfalls. The authors considered it interesting to analyze nine papers, in particular those dedicated to the use of spinal drainage in skull base surgery and in the prevention and/or treatment of CSF fistulas. Two papers describe for the first time pachymeningeal gadolinium enhancement associated with orthostatic headaches, owing to CSF hypotension mimicking an inflammatory or infiltrative disease. The results of the treatment of CSF fistulas are good with a high success rate, avoiding direct surgical repair. The use of a specially designed subarachnoid catheter is clearly superior to the epidural catheter, with good flow of CSF and minimal complications. The main problems are deficient flow and infections. Overdrainage is potentially dangerous, with acute pneumocephalus, brain collapse and neurological deterioration. Infrequent but possible is Chiari II-like syndrome with vocal cord paralysis and life-threatening aspiration, or temporal downward herniation with kinking of the posterior cerebral artery and acute brain infarct. The key to success lies in a rigid protocol, intermittent CSF drainage with a closed circuit, and daily biochemical and microbiological monitoring. Highly qualified medical and nursing staff are essential.

At July 25, 2020, WHO had recorded more than 16.1 million confirmed COVID-19 cases, 1% of them developed critical illness. These patients can experience rapid progression to profound hypoxemia and severe acute respiratory distress syndrome (ARDS). Some patients, despite receiving lung-protective ventilation and maximal medical therapy, develop refractory hypoxemia, rendering candidates for extracorporeal membrane oxygenation (ECMO) support. Centers with experience in this technique are available only in a few reference hospitals and some patients are too ill to be transferred with conventional mechanical ventilation so they need mobile ECMO (interhospital transport under ECMO). Here we report the first interhospital extracorporeal membrane oxygenation transport of a COVID-19 patient in Chile, showing that it is feasible and safe to transfer a COVID-19 patient under ECMO support if a mobile ECMO program is correctly implemented and the particularities of protective measures are properly taken.

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Background: Transcatheter aortic valve implantation (TAVI) is taking a leading

determine the association between the mode of delivery, gestational age, sex and Birth weight with respiratory distress syndrome in neonates admitted in NICU. Methods: this study was performed on all neonates admitted in NICU during 2009 through november 2013.each neonates with final diagnosis of RDS was selected and its information was documented. Data was analysed using Logestic regression test(spss16). Results: from 847 neonate admitted in NICU during this periode, 34/1% were RDS.Mean of gestational age, APGAR(min 5th) and birth weight were 32/87 week,8/88 and 2033/34gr. 71/84% deivered by c/s and 58/4% were male. association between these three variable with RDS were significant(pvalue<./001) odds ratio of birth weight up to 2500, 1500-2500 and lower than 1500 with RDS was 1, 4.119 and 4.6 respectively. Conclusions: these findings are importatnt to obestetricians in the critical decision regarding the timing and mode of delivery and to Nurses who consult and refer women in pregnancy period and may face neonates with respiratory problems.