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El-Battrawy I, Frambach D, Behnes M, Münz B, Lehmann R, Borggrefe M, Akin I. [Subcutaneous cervical and left thoracic emphysema in a 49-year-old woman on ventilation]. Internist (Berl) 2015; 56:1439-44. [PMID: 26530695 DOI: 10.1007/s00108-015-3823-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
We report the case of a 49-year-old woman who was admitted with community-acquired pneumonia. The medical state worsened despite administration of antibiotics. She was intubated and ventilated because of respiratory distress. Several hours after intubation, she developed massive subcutaneous emphysema. The bronchoscopy showed tracheal transmural rupture 3 cm long on the posterior wall of the trachea. The high-risk surgery and massive doses of catecholamine favoured conservative treatment with bilateral endobronchial intubation and veno-venous extracorporeal membrane oxygenation. The patient made a full recovery.
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Affiliation(s)
- I El-Battrawy
- I. Medizinische Klinik (Kardiologie, Angiologie, Pneumologie, Intensivmedizin und klinische Hämostaseologie), Universitätsmedizin Mannheim, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Deutschland.
| | - D Frambach
- I. Medizinische Klinik (Kardiologie, Angiologie, Pneumologie, Intensivmedizin und klinische Hämostaseologie), Universitätsmedizin Mannheim, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Deutschland
| | - M Behnes
- I. Medizinische Klinik (Kardiologie, Angiologie, Pneumologie, Intensivmedizin und klinische Hämostaseologie), Universitätsmedizin Mannheim, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Deutschland
| | - B Münz
- I. Medizinische Klinik (Kardiologie, Angiologie, Pneumologie, Intensivmedizin und klinische Hämostaseologie), Universitätsmedizin Mannheim, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Deutschland
| | - R Lehmann
- I. Medizinische Klinik (Kardiologie, Angiologie, Pneumologie, Intensivmedizin und klinische Hämostaseologie), Universitätsmedizin Mannheim, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Deutschland
| | - M Borggrefe
- I. Medizinische Klinik (Kardiologie, Angiologie, Pneumologie, Intensivmedizin und klinische Hämostaseologie), Universitätsmedizin Mannheim, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Deutschland
| | - I Akin
- I. Medizinische Klinik (Kardiologie, Angiologie, Pneumologie, Intensivmedizin und klinische Hämostaseologie), Universitätsmedizin Mannheim, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Deutschland
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Baumann S, Becher T, Frambach D, Wenz H, Kirschning T, Borggrefe M, Rapp S, Akin I. [Hyponatremia-induced life-threatening cerebral edema after ecstasy use]. Med Klin Intensivmed Notfmed 2015; 111:547-50. [PMID: 26449216 DOI: 10.1007/s00063-015-0099-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Revised: 08/15/2015] [Accepted: 08/30/2015] [Indexed: 11/27/2022]
Abstract
Ecstasy, a psychoactive amphetamine derivative, is a popular party drug. We report the cases of 2 young adults who developed cerebral edema due to hyponatremia. One patient was released from the hospital without any sequelae, whereas the second patient died due to cerebral edema. Severe cases of symptomatic hyponatremia after ecstasy consumption are described in the literature with partially fatal clinical outcomes. Thus, physicians should be aware of early and consequent control of the sodium and choose an interdisciplinary treatment decision.
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Affiliation(s)
- S Baumann
- I. Medizinische Klinik, Abteilung für Kardiologie, Pneumologie, Angiologie und internistische Intensivmedizin, Universitätsmedizin Mannheim, Universität Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Deutschland.
| | - T Becher
- I. Medizinische Klinik, Abteilung für Kardiologie, Pneumologie, Angiologie und internistische Intensivmedizin, Universitätsmedizin Mannheim, Universität Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Deutschland
| | - D Frambach
- I. Medizinische Klinik, Abteilung für Kardiologie, Pneumologie, Angiologie und internistische Intensivmedizin, Universitätsmedizin Mannheim, Universität Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Deutschland
| | - H Wenz
- Abteilung für Neuroradiologie, Universitätsklinikum Mannheim, Universität Heidelberg, Mannheim, Deutschland
| | - T Kirschning
- Klinik für Anästhesiologie und operative Intensivmedizin, Universitätsklinikum Mannheim, Universität Heidelberg, Mannheim, Deutschland
| | - M Borggrefe
- I. Medizinische Klinik, Abteilung für Kardiologie, Pneumologie, Angiologie und internistische Intensivmedizin, Universitätsmedizin Mannheim, Universität Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Deutschland
| | - S Rapp
- I. Medizinische Klinik, Abteilung für Kardiologie, Pneumologie, Angiologie und internistische Intensivmedizin, Universitätsmedizin Mannheim, Universität Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Deutschland
| | - I Akin
- I. Medizinische Klinik, Abteilung für Kardiologie, Pneumologie, Angiologie und internistische Intensivmedizin, Universitätsmedizin Mannheim, Universität Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Deutschland
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Baumann S, Frambach D, Huseynov A, Becher T, Boecker C, Behnes M, Rapp S, Papavassiliu T, Borggrefe M, Akin I. The value of multimodality imaging for detection, characterisation and management of a wall adhering structure in the right atrium. Images Paediatr Cardiol 2014; 16:1-7. [PMID: 26236367 PMCID: PMC4521328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The case presents a wall adherent structure in the right atrium in a young patient with peripheral t-cell lymphoma followed by successful prolonged lysis therapy resulting in the resolution of the thrombus is presented. This case highlights the utility of multimodality imaging in an accurate assessment of the right atrium thrombus and the effectiveness of prolonged lysis therapy.
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Affiliation(s)
- S Baumann
- First Department of Medicine, Faculty of Medicine Mannheim, University Medical Centre Mannheim (UMM), University of Heidelberg, Mannheim, Germany.,Stefan Baumann: First Department of Medicine, Faculty of Medicine Mannheim University Medical Centre Mannheim (UMM), University of Heidelberg, Theodor-Kutzer-Ufer 1-3 68167 Mannheim, Germany. +49 621 383 2381
| | - D Frambach
- First Department of Medicine, Faculty of Medicine Mannheim, University Medical Centre Mannheim (UMM), University of Heidelberg, Mannheim, Germany
| | - A Huseynov
- First Department of Medicine, Faculty of Medicine Mannheim, University Medical Centre Mannheim (UMM), University of Heidelberg, Mannheim, Germany
| | - T Becher
- First Department of Medicine, Faculty of Medicine Mannheim, University Medical Centre Mannheim (UMM), University of Heidelberg, Mannheim, Germany
| | - C Boecker
- First Department of Medicine, Faculty of Medicine Mannheim, University Medical Centre Mannheim (UMM), University of Heidelberg, Mannheim, Germany
| | - M Behnes
- First Department of Medicine, Faculty of Medicine Mannheim, University Medical Centre Mannheim (UMM), University of Heidelberg, Mannheim, Germany
| | - S Rapp
- First Department of Medicine, Faculty of Medicine Mannheim, University Medical Centre Mannheim (UMM), University of Heidelberg, Mannheim, Germany
| | - T Papavassiliu
- First Department of Medicine, Faculty of Medicine Mannheim, University Medical Centre Mannheim (UMM), University of Heidelberg, Mannheim, Germany
| | - M Borggrefe
- First Department of Medicine, Faculty of Medicine Mannheim, University Medical Centre Mannheim (UMM), University of Heidelberg, Mannheim, Germany
| | - I Akin
- First Department of Medicine, Faculty of Medicine Mannheim, University Medical Centre Mannheim (UMM), University of Heidelberg, Mannheim, Germany
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Abstract
A tool was developed that assists surgeons in manipulating surgical instruments more precisely than is possible manually. The tool is a telemanipulator that scales down the surgeon's hand motion and filters tremor in the motion. The signals measured from the surgeon's hand are transformed and used to drive a six-degrees-of-freedom robot to position the surgical instrument mounted on its tip. A pilot study comparing the performance of the telemanipulator system against manual instrument positioning was conducted at the University of Southern California School of Medicine. The results show that a telerobotic tool can improve the performance of a microsurgeon by increasing the precision with which he can position surgical instruments, but this is achieved at the cost of increased time in performing the task. We believe that this technology will extend the capabilities of microsurgeons and allow more surgeons to perform highly skilled procedures currently performed only by the best surgeons. It will also enable performance of new surgical procedures that are beyond the capabilities of even the most skilled surgeons.
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Affiliation(s)
- H Das
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, California, USA.
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