Subject(s)
Hyperkalemia/complications , Hyperkalemia/diagnosis , Kidney Failure, Chronic/complications , Nervous System Diseases/diagnosis , Paralysis/diagnosis , Quadriplegia/diagnosis , Acute Disease , Critical Illness , Diagnosis, Differential , Emergencies , Humans , Kidney Failure, Chronic/diagnosis , Male , Middle Aged , Nervous System Diseases/complications , Paralysis/etiology , Quadriplegia/etiologyABSTRACT
Alteplase used for thrombolysis in ischaemic stroke may be complicated by orolingual acute angioedema (OAA), a rare but potentially life-threatening side effect. We report the case of a 32-year-old woman who over 24 h experienced OAA after thrombolysis for an acute ischaemic left hemispheric stroke. We discuss the pathophysiology of this rare phenomenon.
Subject(s)
Angioedema/chemically induced , Fibrinolytic Agents/adverse effects , Stroke/drug therapy , Tissue Plasminogen Activator/adverse effects , Tongue Diseases/chemically induced , Adult , Angioedema/diagnosis , Female , Fibrinolytic Agents/therapeutic use , Humans , Tissue Plasminogen Activator/therapeutic use , Tongue Diseases/diagnosisABSTRACT
PURPOSE: The purpose of this study was to compare the prognosis of medical versus surgical patients developing ventilator-associated pneumonia (VAP). MATERIALS AND METHODS: An observational cohort study included 125 consecutive patients exhibiting VAP. Incidence of death occurred at two different times: during intensive care unit (ICU) stay and during hospital stay. RESULTS: Eighty-seven patients were included in the medical group and 38 in the surgical group. On ICU admission and at the time of VAP onset, most collected data, such as demographic parameters, severity of underlying diseases, and current illness, risk factors forVAP development andVAP characteristics were similar in the two groups. Mortality rates during ICU and hospital stays were not significantly different in medical (49%, 56%) and surgical (55%, 61%) groups. In multivariate logistic regression model adjusting for main factors of VAP mortality, surgical admittance status demonstrated no significant impact on mortality assessed during ICU stay (AOR = 1.6; 0.6 - 4.3 CI) and during hospital stay (AOR = 1.6; 0.6 - 4.2 CI). CONCLUSIONS: In this series, after adjustment for mortality confounding factors, medical versus surgical admittance status was not a significant determinant of VAP mortality.
