ABSTRACT
Intraoperative extracorporeal membrane oxygenation (ECMO) support, both venoarterial and venovenous (VV), have been used sparingly and with limited success in the setting of liver transplantation. Here, we report the successful use of VV-ECMO in the resuscitation and pulmonary bridging support after severe systemic inflammatory response in a combined liver and kidney transplant recipient who suffered primary nonfunction of both allografts. Where conventional ventilator maneuvers may prove ineffective, the implementation of VV-ECMO should be considered as a therapeutic option in limited, short-lived acute pulmonary injury.
Subject(s)
Extracorporeal Membrane Oxygenation/methods , Liver Transplantation/adverse effects , Respiratory Distress Syndrome/etiology , Respiratory Distress Syndrome/therapy , Acute Lung Injury/etiology , Acute Lung Injury/therapy , Humans , Kidney Transplantation/adverse effects , Male , Middle Aged , Postoperative Complications/etiology , Postoperative Complications/therapy , ReoperationABSTRACT
First described in the United States in the late 1990s, West Nile virus (WNV) infection following solid organ transplantation is a rare but life-threatening complication. The many ways in which WNV may be acquired, patient specific risk factors, and variability in clinical severity present challenges to health care providers caring for these patients.
Subject(s)
Heart Transplantation/adverse effects , West Nile Fever/transmission , Aged , Fatal Outcome , Humans , Male , West Nile virusABSTRACT
There are summarized results of studies on peculiarities of formation of compensatory-adaptive mechanisms of brain circulation and respiration at oxygen-dependent energy deficit in the 3-6-year old children with delayed consequences of perinatal CNS lesion of the hypoxic-ischemic genesis and delay of psychic development (DPD) with use of the systemic-integrative approach and of parameters of superslow information-control systems of brain and of organism. In the examined contingent of children, differences have been revealed in development of emotional sphere and the higher psychic functions depending on character of disorganization of regulatory CNS functions and of the type of formed compensatory-adaptive mechanisms of autoregulation of cerebral circulation and of the system of external respiration.
Subject(s)
Brain/physiopathology , Cognition , Developmental Disabilities/physiopathology , Energy Metabolism , Homeostasis , Hypoxia-Ischemia, Brain/complications , Adaptation, Physiological , Brain/blood supply , Case-Control Studies , Child , Child, Preschool , Developmental Disabilities/diagnosis , Developmental Disabilities/etiology , Emotions , Female , Humans , Hypoxia-Ischemia, Brain/physiopathology , Male , Oxygen ConsumptionABSTRACT
This study outlines a genealogy of the French and United States' Emergency Medical Service (EMS) systems. This is done to contextualise claims that Princess Diana could have survived had her crash taken place in the USA, and to enrich the EMS debate regarding field-treatment vs. rapid hospital admission for trauma victims. A historical analysis is offered for the disproportionate amount of available data on penetrating trauma, and proportionate deficit of data on blunt trauma with respect to total North American and Western European trauma epidemiology. The impact of US biomedical knowledge and culture on French medical practice is evaluated and used to understand how foreign knowledge is negotiated in local medical practice. The paper concludes by showing how, in response to a challenge by American biomedical standards of practice and formulation of competence, French pre-hospital Emergency Physicians have contextualised the origins of these standards as well as their local relevance in order to preserve an integrated notion of competence.
