BACKGROUND Venovenous extracorporeal membrane oxygenation(V-V ECMO)has become an important treatment for severe pneumonia,but there are various complications during the treatment.This article describes a case with sev...BACKGROUND Venovenous extracorporeal membrane oxygenation(V-V ECMO)has become an important treatment for severe pneumonia,but there are various complications during the treatment.This article describes a case with severe pneumonia success-fully treated by V-V ECMO,but during treatment,the retrovenous catheter,which was supposed to be in the right internal vein,entered the superior vena cava directly in the mediastinum.The ECMO was safely withdrawn after multidiscip-linary consultation.Our experience with this case is expected to provide a reference for colleagues who will encounter similar situations.CASE SUMMARY A 64-year-old man had severe pulmonary infection and respiratory failure.He was admitted to our hospital and was given ventilation support(fraction of inspired oxygen 100%).The respiratory failure was not improved and he was treated by V-V ECMO,during which the venous return catheter,which was supposed to be in the right internal vein,entered the superior vena cava directly in the mediastinum.There was a risk of massive mediastinal bleeding if the catheter was removed directly when the ECMO was withdrawn.Finally,the patient underwent vena cava angiography+balloon attachment+ECMO with-drawal in the operating room(prepared for conversion to thoracotomy for vascular exploration and repair at any time during surgery)after multidiscip-linary consultation.ECMO was safely withdrawn,and the patient recovered and was discharged.CONCLUSION Patients may have different vascular conditions.Multidisciplinary cooperation can ensure patient safety.Our experience will provide a reference for similar cases.展开更多
Total dissolved gas(TDG) supersaturation caused by dam sluicing can result in gas bubble trauma(GBT) in fish and threaten their survival.In the present study,Chinese suckers(Myxocyprinus asiaticus Bleeker) were expose...Total dissolved gas(TDG) supersaturation caused by dam sluicing can result in gas bubble trauma(GBT) in fish and threaten their survival.In the present study,Chinese suckers(Myxocyprinus asiaticus Bleeker) were exposed to TDG supersaturated water at levels ranging from 120% to 145% for 48 h.The median lethal concentration(LC 50) and the median lethal time(LT 50) were determined to evaluate acute lethal effects on Chinese suckers.The results showed that the LC 50 values of 4,6,8,and 10 h were 142%,137%,135%,and 130%,respectively.The LT 50 values were 3.2,4.7,7.8,9.2,and 43.4 h,respectively,when TDG supersaturated levels were 145%,140%,135%,130%,and 125%.Furthermore,the biological responses in Chinese suckers were studied by assaying the catalase(CAT) activities in gills and muscles at the supersaturation level of 140% within LT 50.The CAT activities in the gills and muscle tissues exhibited a regularity of a decrease after an increase.CAT activities in the muscles were increased significantly at 3/5LT 50(P<0.05) and then came back to the normal level.However,there were no significant differences between the treatment group(TDG level of 140%) and the control group(TDG level of 100%) on CAT activities in the gills before 3/5LT 50(P>0.05),but the activities were significantly lower than the normal level at 4/5LT 50 and LT 50(P<0.05).展开更多
文摘BACKGROUND Venovenous extracorporeal membrane oxygenation(V-V ECMO)has become an important treatment for severe pneumonia,but there are various complications during the treatment.This article describes a case with severe pneumonia success-fully treated by V-V ECMO,but during treatment,the retrovenous catheter,which was supposed to be in the right internal vein,entered the superior vena cava directly in the mediastinum.The ECMO was safely withdrawn after multidiscip-linary consultation.Our experience with this case is expected to provide a reference for colleagues who will encounter similar situations.CASE SUMMARY A 64-year-old man had severe pulmonary infection and respiratory failure.He was admitted to our hospital and was given ventilation support(fraction of inspired oxygen 100%).The respiratory failure was not improved and he was treated by V-V ECMO,during which the venous return catheter,which was supposed to be in the right internal vein,entered the superior vena cava directly in the mediastinum.There was a risk of massive mediastinal bleeding if the catheter was removed directly when the ECMO was withdrawn.Finally,the patient underwent vena cava angiography+balloon attachment+ECMO with-drawal in the operating room(prepared for conversion to thoracotomy for vascular exploration and repair at any time during surgery)after multidiscip-linary consultation.ECMO was safely withdrawn,and the patient recovered and was discharged.CONCLUSION Patients may have different vascular conditions.Multidisciplinary cooperation can ensure patient safety.Our experience will provide a reference for similar cases.
基金Project supported by the National Natural Science Foundation ofChina (No. 50979063)the Scientific Research Foundation for Young Teachers of Xihua University (No. Z1120412),China
文摘Total dissolved gas(TDG) supersaturation caused by dam sluicing can result in gas bubble trauma(GBT) in fish and threaten their survival.In the present study,Chinese suckers(Myxocyprinus asiaticus Bleeker) were exposed to TDG supersaturated water at levels ranging from 120% to 145% for 48 h.The median lethal concentration(LC 50) and the median lethal time(LT 50) were determined to evaluate acute lethal effects on Chinese suckers.The results showed that the LC 50 values of 4,6,8,and 10 h were 142%,137%,135%,and 130%,respectively.The LT 50 values were 3.2,4.7,7.8,9.2,and 43.4 h,respectively,when TDG supersaturated levels were 145%,140%,135%,130%,and 125%.Furthermore,the biological responses in Chinese suckers were studied by assaying the catalase(CAT) activities in gills and muscles at the supersaturation level of 140% within LT 50.The CAT activities in the gills and muscle tissues exhibited a regularity of a decrease after an increase.CAT activities in the muscles were increased significantly at 3/5LT 50(P<0.05) and then came back to the normal level.However,there were no significant differences between the treatment group(TDG level of 140%) and the control group(TDG level of 100%) on CAT activities in the gills before 3/5LT 50(P>0.05),but the activities were significantly lower than the normal level at 4/5LT 50 and LT 50(P<0.05).
