RESUMO
Sedation in paediatric MR is a necessary choice because very often we are dealing with uncooperative patients about to undergo lengthy examinations. The aim of this a retrospective study is to demonstrate that profound sedation with halogenated vapour Sevorane, together with specific systems for monitoring vital signs, is a safe and reliable technique. In accordance with current guidelines, it is considered essential to have an expert anaesthetist present in order to reduce the risk of incidents, which, in the case of difficulty in the airways, as seen in literature, could have fatal outcomes.
Assuntos
Encefalopatias/etiologia , Intoxicação por Monóxido de Carbono/complicações , Encefalopatias/sangue , Encefalopatias/diagnóstico por imagem , Intoxicação por Monóxido de Carbono/sangue , Intoxicação por Monóxido de Carbono/diagnóstico por imagem , Coma/sangue , Coma/diagnóstico por imagem , Coma/etiologia , Humanos , Oxigenoterapia Hiperbárica , Masculino , Pessoa de Meia-Idade , RadiografiaRESUMO
Emphasis is placed on the need for a careful appraisal of the history in the diagnostic and prognostic approach to mushroom poisoning. The main syndromes are described and an account is given of the modern treatment of the dramatic pictures caused by phalloides poisoning. A personal case series formed of 118 patients treated between Jan. 1969 and Dec. 1977 is presented. The importance of certain methods, especially dialysis, in the management of phalloides cases is discussed. Stress if laid on the need to hospitalise all persons displaying symptoms referable to the ingestion of mushrooms in suitable equipped centres as soon as possible.
Assuntos
Intoxicação Alimentar por Cogumelos/fisiopatologia , Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Intoxicação Alimentar por Cogumelos/diagnóstico , Intoxicação Alimentar por Cogumelos/terapiaRESUMO
The clinical course of a young woman following the ingestion of the herbicide Paraquat in a suicide attempts is reported. Clinical signs of intoxication consisted at first in alterations of hepatic and renal functions, and later in progressive pulmonary failure. The patient died in severe respiratory distress on the 8th day due to cardiac arrest, probably anoxic. Treatment was initially on standard lines, with cathartics with the aim to prevent the absorption of Paraquat in the plasma and its accumulation in the lungs. In addition, high doses of steroids, immunosuppressive agents, prophylactic antibiotics and cardiotonics were given. Peritoneal dialysis and haemodialysis were concomitantly assured. The Authors suggest that in Paraquat poisoning an adequate therapeutic treatment could consist in specific sorbents such as Fuller's earth and bentonite, haemoperfusion over a coated charcoal system or cation exchange resins. Administration of drugs such as corticosteroids, immunosuppressants (bleomycine) and the enzyme superoxide dismutase may be also indicated. On the contrary, oxygen therapy should be carefully monitored: in fact hyperoxic atmospheres, by increasing the rate of generation of superoxide radicals, enhance cellular toxicity of Paraquat.
