Assuntos
Enfermagem de Cuidados Críticos/normas , Fibrinolíticos/normas , Fibrinolíticos/uso terapêutico , Embolia Pulmonar/tratamento farmacológico , Embolia Pulmonar/enfermagem , Ativador de Plasminogênio Tecidual/normas , Ativador de Plasminogênio Tecidual/uso terapêutico , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Guias de Prática Clínica como Assunto , Estados UnidosRESUMO
Venovenous (V-V) extracorporeal membrane oxygenation (ECMO) is used for respiratory failure that is suspected to be reversible (bridge to recovery), or as a bridge to lung transplantation. Patients with proximal airway obstruction due to endobronchial malignancy can develop acute respiratory failure, and may benefit from V-V ECMO as a bridge to airway intervention, further treatment, and eventual recovery. We describe a case of a superior sulcus tumor with tracheobronchial and superior vena cava invasion causing both respiratory failure and superior vena cava syndrome. This was treated successfully with V-V ECMO, bronchial stenting, and radiotherapy.
Assuntos
Oxigenação por Membrana Extracorpórea/métodos , Síndrome de Pancoast/complicações , Insuficiência Respiratória/terapia , Síndrome da Veia Cava Superior/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Insuficiência Respiratória/etiologia , Síndrome da Veia Cava Superior/etiologiaRESUMO
Venous thromboembolism is the third leading cause of cardiovascular death in the United States and is the second leading cause of death among hospitalized cancer patients. Continued controversy exists regarding the role of thrombolytic therapy among patients with acute pulmonary embolism. Limited research exists on thrombolytic therapy in this setting, most of which has focused on symptoms, including right ventricular function, hemodynamic status, and electrocardiographic changes. However, these studies have excluded patients with a known malignancy. Presented is an interesting case of a patient, in remission from breast cancer, who presented to the emergency department with symptomatic pulmonary emboli. The presentation, medical management, and consequences of the treatment have been discussed. Also, a brief review of the literature is presented regarding the treatment of acute pulmonary embolism.
Assuntos
Cuidados Críticos , Embolia Pulmonar/enfermagem , Doença Aguda , Idoso , Evolução Fatal , Feminino , Humanos , Embolia Pulmonar/diagnóstico , Embolia Pulmonar/fisiopatologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do TratamentoRESUMO
The transport of critically ill patients is challenging for nurses and patients alike. It is imperative that patient safety be the primary focus. The use of a specialized transport team can help to alleviate many of the adverse effects of the transport.