HighlightsSpontaneous hepatic rupture is a rare complication of preeclampsia and HELLP syndrome.It carries a high maternal and perinatal mortality.Multidisciplinary management is key to optimal outcomes.Usual management includes perihepatic packing or angioembolization but formal lobectomy may be required in special cases.
La cirugía de abdomen abierto para el manejo de algunas patologías severas en obstetricia ha aumentado y actualmente es común en muchas de nuestras pacientes. Los beneficios incluyen la prevención y tratamiento del Síndrome de Hipertensión Intraabdominal (HIA), de las infecciones de la cavidad peritoneal y el del Síndrome Compartimental Abdominal (SCA) secundario a enfermedades potencialmente catastróficas como la preeclampsia severa y Síndrome de HELLP. La presente revisión explora los mecanismos de infección, las consecuencias fisio-patológicas del SCA y las nuevas técnicas quirúrgicas de la cirugía de abdomen abierto para el manejo adecuado de estas entidades.
all CXR images were urgently acquired, and their average time was 43 minutes from order to availability. Before intervention, the median number of CXRs per patient per day was 0.38 (0.36 -0.40). After, this amount decreased to 0.30 (0.28 -0.32) [p= 0.0013], representing a 22% reduction on CXR request. Mean length of ICU stay before and after campaign was, respectively, 8.14 (7.79 -8.71) and 8.45 (8.24 -9.74) days [p= 0.35]. Mean mortality rate before and after intervention was, respectively, 18.45% (6 3.87%) and 21.58% (6 2.23%) [p = 0.12]. Conclusions: This was the first report of a Choosing Wisely initiative in a Brazilian ICU of a public hospital. Transition to a high value on-demand CXR strategy in ICUs is safe and particularly noteworthy in a low resource public health system.
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.