Critical Care and Shock

May 2006

Multiple Shotgun Pellet Embolization to the Pulmonary Artery

Pellet embolization to the pulmonary artery from a shotgun injury is a rare event. Our current experience with this entity is described. We reviewed the literature of Bullet Embolization with emphasis on management. We believe that shotgun pellet pulmonary artery embolism should be regarded as a separate entity from bullet embolism. The mechanism of injury and its sequelae, leading to complication is very much subtle compared to bullet embolism per se.

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A Case of Strongyloides Stercoralis Hyperinfection Syndrome

It is known that Strongyloides stercoralis can induce intestinal strongyloidiasis, hyperinfection syndrome or disseminated strongyloidiasis. Paralytic ileus and associated bacterial infections may be seen as complications of hyperinfection syndrome or disseminated disease. This report discusses a case of hyperinfection syndrome in a patient who was receiving chronic immunosuppressive treatment for rheumatoid arthritis.

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Opening Up to Lung Recruitment. Pulmonary Contusion and Derecruitment – The Role of Inflammation

Purpose of review: It was recently reported that a lung protective ventilation strategy resulted in no fatalities in 17 patients with ARDS secondary to lung contusion. Although the efficacy of a lung protective ventilation strategy to reduce mortality in ARDS patients has been demonstrated, the underlying mechanisms for this reduction remain unclear. Recent findings: ARDS is characterized by an inflammatory state of the lung that can be aggravated by mechanical ventilation.

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Clevidipine: A Unique Agent for the Critical Care Practitioner

Clevidipine is a new third generation intravenous dihydropyridine calcium channel blocker. It is a specific arterial vasodilator developed for the acute reduction and control of arterial blood pressure in the perioperative period. This drug has an extremely short half life and is rapidly metabolized by tissue and plasma esterases. Clevidipine is a potent arterial vasodilator with very little or no effect of the myocardial contractility and venous capacitance and also minimal side effects. Clevidipine can also theoretically help to protect against organ reperfusion injury.

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