<strong>Background and Goal of Study:</strong> Intraoperative awareness is a serious but preventable complication of general anaesthesia. Bispectral index (BIS) is the most widely used method monitoring an...<strong>Background and Goal of Study:</strong> Intraoperative awareness is a serious but preventable complication of general anaesthesia. Bispectral index (BIS) is the most widely used method monitoring anaesthesia depth. BIS monitoring requires attachment of forehead sensors, which poses a challenge when the surgical field involves the forehead. We aimed to compare the gold standard forehead position of BIS sensors with an alternative position across the nasal dorsum for neurosurgical procedures.<strong> Materials and Methods: </strong>After ethical committee approval and informed consent were obtained, 62 patients were enrolled in this prospective observational study. Frontal and nasal BIS values were compared in all patients.<strong> Results and Discussion:</strong> The mean BIS value from frontal versus nasal sensors was 49 ± 22 and 49 ± 21 respectively (n: 62). These values were statistically correlated (ICC 0.78, p < 0.001) indicating that nasal BIS measurement does not present a disadvantage for routine use when needed. <strong>Conclusion:</strong> Our data reveal that for measuring anesthesia depth, BIS sensor placement on the nasal dorsum shows comparable efficiency in comparison to standard frontal展开更多
Background: <em>Raoultella planticola</em> is a gram-negative rod-shaped bacterium commonly found in water and soil and considered to be a rare and possibly underestimated cause of severe human infection. ...Background: <em>Raoultella planticola</em> is a gram-negative rod-shaped bacterium commonly found in water and soil and considered to be a rare and possibly underestimated cause of severe human infection. Its presence should be suspected in older patients with a history of cancer, immune suppression and recent exposure to traumatic injuries or invasive medical procedures. Case presentation: A 78-year-old male with a history of hypertension was diagnosed with pancreatic adenocarcinoma. Whipple procedure (pancreaticoduodenectomy) was performed afterwards. On the 8th day of surgery, the patient was admitted to our tertiary ICU with septic shock. His initial Sequential Organ Failure Assessment (SOFA) score was 12 with predicted mortality 95.7%. Empirical antibiotic therapy with colymicin, meropenem and teikoplanin was administered immediately and two sets of blood cultures were obtained. Patient developed refractory septic shock despite the addition of vasopressin and the patient’s condition continued to deteriorate. Patient died on the third day of sepsis. His blood culture was positive for <em>R.</em> <em>planticola</em>, which was identified using the VITEK-2 biochemical identification system. Conclusions: Clinicians should be aware of fatal unusual infections in immunocompromised patients.展开更多
文摘<strong>Background and Goal of Study:</strong> Intraoperative awareness is a serious but preventable complication of general anaesthesia. Bispectral index (BIS) is the most widely used method monitoring anaesthesia depth. BIS monitoring requires attachment of forehead sensors, which poses a challenge when the surgical field involves the forehead. We aimed to compare the gold standard forehead position of BIS sensors with an alternative position across the nasal dorsum for neurosurgical procedures.<strong> Materials and Methods: </strong>After ethical committee approval and informed consent were obtained, 62 patients were enrolled in this prospective observational study. Frontal and nasal BIS values were compared in all patients.<strong> Results and Discussion:</strong> The mean BIS value from frontal versus nasal sensors was 49 ± 22 and 49 ± 21 respectively (n: 62). These values were statistically correlated (ICC 0.78, p < 0.001) indicating that nasal BIS measurement does not present a disadvantage for routine use when needed. <strong>Conclusion:</strong> Our data reveal that for measuring anesthesia depth, BIS sensor placement on the nasal dorsum shows comparable efficiency in comparison to standard frontal
文摘Background: <em>Raoultella planticola</em> is a gram-negative rod-shaped bacterium commonly found in water and soil and considered to be a rare and possibly underestimated cause of severe human infection. Its presence should be suspected in older patients with a history of cancer, immune suppression and recent exposure to traumatic injuries or invasive medical procedures. Case presentation: A 78-year-old male with a history of hypertension was diagnosed with pancreatic adenocarcinoma. Whipple procedure (pancreaticoduodenectomy) was performed afterwards. On the 8th day of surgery, the patient was admitted to our tertiary ICU with septic shock. His initial Sequential Organ Failure Assessment (SOFA) score was 12 with predicted mortality 95.7%. Empirical antibiotic therapy with colymicin, meropenem and teikoplanin was administered immediately and two sets of blood cultures were obtained. Patient developed refractory septic shock despite the addition of vasopressin and the patient’s condition continued to deteriorate. Patient died on the third day of sepsis. His blood culture was positive for <em>R.</em> <em>planticola</em>, which was identified using the VITEK-2 biochemical identification system. Conclusions: Clinicians should be aware of fatal unusual infections in immunocompromised patients.
