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Post by tyson on Aug 1, 2015 19:46:29 GMT -5
I had interesting case the other week. 27 year old male w a pmh significant for neurofibromatosis who presented w ams and respiratory failure. Had to be bagged by ems, non responsive, was tubed upon presentation. Initial abg showed co2 of 94. Ended up scanning head and abdomen. Did abdomen bc portable chest x Ray showed dilated bowel loops. Ended up w intussuception and sbo. Went to surgery. Likely this guy abdomen became so large and distended the diaphragm couldn't comtract and properly ventilate lungs. Not a usual cause of respiratory failure. Anyone had any interesting causes of respiratory failure that's not one of the usual culprits??
Tyson
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Post by kemple on Aug 21, 2015 18:13:35 GMT -5
That's a good one, abdominal compartment syndrome basically.
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Post by pbruss on Sept 3, 2015 13:40:20 GMT -5
who can tell me how do you diagnose abd compartment synrdome? mybe some one besides tyson, stransky or kemple
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Post by pbruss on Sept 7, 2015 15:17:53 GMT -5
ok os you measure the pressure in the bladder. a little infor below.
"The magnitude of this syndrome and the involvement of the various organs depend on the level of the intra-abdominal pressure. The normal intra-abdominal pressure ranges between 0 and 5 mmHg. When it is mildly increased to between 10 and 15 mmHg, cardiac index is usually maintained or even increased because abdominal viscera are mildly squeezed and venous return increases. Respiratory and renal symptoms are unlikely to occur. Hepatosplanchnic blood flow may decrease [5]. At this point, intravascular volume optimization will probably correct these alterations. When intra-abdominal pressure is moderately increased to between 15 and 25 mmHg the full syndrome may be observed, but usually responds to aggressive fluid resuscitation, and surgical decompression should be considered. At high pressures (< 25 mmHg) surgical decompression associated with fluid resuscitation and transient use of vasoconstrictive agents is mandatory. When surgical decompression is not feasible, application of a negative abdominal pressure should be considered [6,7]."
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Post by omizixaba on May 19, 2019 11:37:57 GMT -5
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Post by vonaiji on May 19, 2019 13:32:38 GMT -5
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