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Search Results (3)

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Keywords = tension pneumoperitoneum

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6 pages, 1617 KB  
Case Report
Gastric Perforation from Bag-Valve-Mask Ventilation Resulting in Tension Pneumoperitoneum and Arterial Insufficiency
by Victor Boya Yang, Annabelle Pan, Kent Allen Stevens and James Earl Harris
Trauma Care 2024, 4(3), 200-205; https://doi.org/10.3390/traumacare4030017 - 22 Aug 2024
Cited by 1 | Viewed by 3974
Abstract
We report the case of a 44-year-old woman who suffered gastric perforation after receiving bag-valve-mask (BVM) ventilation in the setting of alcohol intoxication. She had a markedly distended abdomen and cold, dusky lower extremities upon arrival to the emergency department. Imaging revealed a [...] Read more.
We report the case of a 44-year-old woman who suffered gastric perforation after receiving bag-valve-mask (BVM) ventilation in the setting of alcohol intoxication. She had a markedly distended abdomen and cold, dusky lower extremities upon arrival to the emergency department. Imaging revealed a large volume intra-abdominal accumulation of air with compression of the aorta. Needle decompression relieved symptoms of lower extremity arterial insufficiency. However, the patient quickly decompensated and subsequent exploratory laparotomy confirmed gastric rupture. A subtotal gastrectomy was performed but the patient ultimately passed on post-operative day two due to multi-organ dysfunction. Although BVM ventilation is commonplace in both the hospital and field, there is a lack of awareness of the serious complications of abdominal air accumulation due to their rareness in the adult population. Checking for abdominal distention during resuscitation ought to be routine in all patients. Signs of arterial insufficiency accompanying abdominal distention, once confirmed by diagnostic imaging that shows extensive pneumoperitoneum, are indicators of having reached a life-threatening level of air accumulation, calling for immediate needle decompression and exploratory laparotomy. Full article
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11 pages, 1107 KB  
Article
Volume-Controlled Versus Dual-Controlled Ventilation during Robot-Assisted Laparoscopic Prostatectomy with Steep Trendelenburg Position: A Randomized-Controlled Trial
by Jin Ha Park, In Kyeong Park, Seung Ho Choi, Darhae Eum and Min-Soo Kim
J. Clin. Med. 2019, 8(12), 2032; https://doi.org/10.3390/jcm8122032 - 21 Nov 2019
Cited by 15 | Viewed by 3782
Abstract
Dual-controlled ventilation (DCV) combines the advantages of volume-controlled ventilation (VCV) and pressure-controlled ventilation (PCV). Carbon dioxide (CO2) pneumoperitoneum and steep Trendelenburg positioning for robot-assisted laparoscopic radical prostatectomy (RALRP) has negative effects on the respiratory system. We hypothesized that the use of [...] Read more.
Dual-controlled ventilation (DCV) combines the advantages of volume-controlled ventilation (VCV) and pressure-controlled ventilation (PCV). Carbon dioxide (CO2) pneumoperitoneum and steep Trendelenburg positioning for robot-assisted laparoscopic radical prostatectomy (RALRP) has negative effects on the respiratory system. We hypothesized that the use of autoflow as one type of DCV can reduce these effects during RALRP. Eighty patients undergoing RALRP were randomly assigned to receive VCV or DCV. Arterial oxygen tension (PaO2) as the primary outcome, respiratory and hemodynamic data, and postoperative fever rates were compared at four time points: 10 min after anesthesia induction (T1), 30 and 60 min after the initiation of CO2 pneumoperitoneum and Trendelenburg positioning (T2 and T3), and 10 min after supine positioning (T4). There were no significant differences in PaO2 between the two groups. Mean peak airway pressure (Ppeak) was significantly lower in group DCV than in group VCV at T2 (mean difference, 5.0 cm H2O; adjusted p < 0.001) and T3 (mean difference, 3.9 cm H2O; adjusted p < 0.001). Postoperative fever occurring within the first 2 days after surgery was more common in group VCV (12%) than in group DCV (3%) (p = 0.022). Compared with VCV, DCV did not improve oxygenation during RALRP. However, DCV significantly decreased Ppeak without hemodynamic instability. Full article
(This article belongs to the Section Anesthesiology)
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2 pages, 581 KB  
Case Report
Tension Pneumoperitoneum: Innovative Decompression of This General Surgical Emergency
by Alun E. Jones, Dean Godfrey and Guy F. Nash
Surg. Tech. Dev. 2011, 1(2), e21; https://doi.org/10.4081/std.2011.e21 - 10 Oct 2011
Viewed by 1
Abstract
We describe the novel use of a cannula in decompressing a large tension pneumoperitoneum secondary to perforated sigmoid diverticulum, in which the patient did not subsequently require an emergency laparotomy. Needle decompression was successfully used as part of a conservative regimen, thus avoiding [...] Read more.
We describe the novel use of a cannula in decompressing a large tension pneumoperitoneum secondary to perforated sigmoid diverticulum, in which the patient did not subsequently require an emergency laparotomy. Needle decompression was successfully used as part of a conservative regimen, thus avoiding potentially high-risk surgery. Full article
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