Search

Globoka venska tromboza spodnjih okončin je pogost razlog za obravnavo bolnika v urgentni ambulanti. Kljub temu so napredovale oblike globoke venske tromboze redke (npr. phlegmasia cerulea dolens). Lokalna katetrska tromboliza velja za terapijo izbora pri zdravljenju napredovalih oblik globoke venske tromboze, kot je phlegmasia cerulea dolens. V članku bomo predstavili prvi primer tovrstnega zdravljenja v Univerzitetnem kliničnem centru Maribor (UKC Maribor).

Purpose: Many critically ill patients require a tracheotomy during their ICU (Intensive Care Unit) stay. The aim of this study was to determine how many patients that undergo this procedure survive the hospital stay and are alive 1 year after the procedure. Methods: We retrospectively included 144 patients who had tracheotomies during their ICU stay at the UMC (University Medical Centre) Maribor in 2015 and compared the survival between patients hospitalized in the MICU (Medical Intensive Care Unit) and SICU (Surgical Intensive care unit). Results: This study showed that survival after tracheotomy in critically ill patients is low. Only 9.7% of all patients live without a tracheostomy after 1 year. The differences that were statistically significant between the MICU and SICU were observed only after the discharge from the ICU, with more people survivingthe MICU stay. Conclusions: There is little information involving 1-year survival rates of patients undergoing tracheotomies. We conclude that more studies regarding this issue need to be conducted.

Purpose: We report on the first patient with refractory hypoxemia treated with venovenous extracorporeal membrane oxygenation (VV ECMO) at the Medical Intensive Care Unit of the University Medical Centre Maribor. Case report: A 52-year-old male was admitted after successful cardiopulmonary resuscitation from out-of-hospital cardiac arrest (first rhythm was ventricular fibrillation, with 40 min to return of spontaneous circulation). The patient underwent primary percutaneous revascularization of the left anterior descendingcoronary artery with insertion of one coronary stent. Hypoxemia was present during patient transportation and the procedure and continued to worsen after admission. Due to refractory hypoxemia caused by aspiration pneumonia, treatment with the VV ECMO was initiated. The ECMO procedure wasperformed without complications and led to improvement in gas exchange and lung mechanics. The patient was then successfully weaned from ECMO, decannulated, and extubated. After extubation, the patient’s course of treatment was complicated by hospital pneumonia and catheter-related blood stream infection.As his state deteriorated, reintubation was necessary. Despite intensive treatment, the patient died on day 30. Conclusions: Response to the VV ECMO treatment of refractory hypoxemia due to aspiration pneumonia was positive and without complications. In spite of initial improvement, the patient died after several weeks due to recurring infection and septic shock.