May 2006 - Critical Care and Shock

Multiple Shotgun Pellet Embolization to the Pulmonary Artery

Ferdinand Rico 02/05/2006

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.

Hypothyroidism Induced Cardiac Tamponade in Intensive Care Unit—A Rare Presentation

Salim R. Surani 02/05/2006

Hypothyroidism is common disease with multisystem involvement. Pericardial tamponade secondary to hypothyroidism is extremely rare. In current paper we describe a case of middle age Hispanic man presenting with pericardial tamponade due to severe hypothyroidism, and discuss the relevant literature.

A Case of Strongyloides Stercoralis Hyperinfection Syndrome

Pejman Soheili 02/05/2006

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.

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

Jack J. Haitsma 02/05/2006

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.

Clevidipine: A Unique Agent for the Critical Care Practitioner

Gabriela Rodríguez 02/05/2006

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.