RESUMO
PURPOSE: Photo-optical TCpO2 (pTCpO2) has been proposed as a new method to determine the partial oxygen pressure of the lower extremity in patients with peripheral arterial disease. It is aimed to determine the level of agreement between pTCpO2 and the traditional electro-chemical transcutaneous oxygen tension measurement (eTCpO2). METHODS: Eighteen patients with intermittent claudication underwent simultaneous ankle-brachial index measurement, toe-pressure, pTCpO2 and eTCpO2 tests. Oxygen tension levels were measured on anterior chest and calf prior in rest (T0), during induced ischemia (T1) and after blood flow restoration (T2). TCpO2 agreement was assessed according to the principles of Bland and Altman. RESULTS: Absolute average TCpO2 values differed between eTCpO2 and pTCpO2 for calf in T2 (38,1 mmHg (σ 14,4) vs. 49,8 (σ 22.3) with P = 0.35). The Bland-Altman plots demonstrated eTCpO2 and pTCpO2 bias of 3,7 mmHg (σ 18,8), 11,6 mmHg (σ 17,6) and 6,7 mmHg (σ 23,5) for T0, T1 and T2 for the calf. CONCLUSION: pTCpO2 is in agreement with eTCpO2 in measuring pO2 levels of the lower extremity in rest and during induced ischemia in patients with vascular claudication. The large variability between eTCpO2 and pTCpO2 should be accounted for, while pTCpO2 values have a tendency to demonstrate higher values in comparison to eTCpO2.
Assuntos
Monitorização Transcutânea dos Gases Sanguíneos , Técnicas Eletroquímicas , Claudicação Intermitente/diagnóstico , Oxigênio/sangue , Doença Arterial Periférica/diagnóstico , Fotometria , Pele/irrigação sanguínea , Idoso , Biomarcadores/sangue , Teste de Esforço , Estudos de Viabilidade , Feminino , Humanos , Claudicação Intermitente/sangue , Claudicação Intermitente/fisiopatologia , Masculino , Pessoa de Meia-Idade , Doença Arterial Periférica/sangue , Doença Arterial Periférica/fisiopatologia , Valor Preditivo dos TestesRESUMO
Flail chest after blunt trauma to the chest has a high morbidity and mortality rate. Traumatic flail chest in children rarely occurs due to flexibility of the ribcage. We describe the case of a 13-year-old boy sustaining a flail chest after a high-energy trauma. Conservative treatment with proper mechanical ventilation and pain management was unsuccessful, and was followed by operative rib fixation. The patient was discharged home 17â days after surgery and, at 4â months follow-up, had fully recovered. This case report shows the possibility of operative rib fixation as treatment for flail chest in children.
