Figure 1 - uploaded by Subrahmanyan Radhakrishna
Content may be subject to copyright.
Chest radiograph showing right-sided pneumothorax (thin arrow) and pneumomediastinum (thick arrow).
Contexts in source publication
Context 1
... 1 or 2, and distinguishing between these grades was dif®cult. To better describe the laryngeal views recorded with the imaging system we devised the percentage of glottic opening (POGO) score [12]. The POGO score represents the percentage of glottic opening seen, de®ned by the linear span from the anterior commisure to the interaryte- noid notch (Fig. 1). A 100% POGO score is a full view of the glottis from the anterior commisure to the interary- tenoid notch. A POGO score of 0 means that even the interarytenoid notch is not seen. The POGO score replaces CL grades 1 and 2 with a continuous numeri- cal value. Unlike CL grading, POGO score is not dependent upon visualisa- tion of the ...
Context 2
... recently conducted a study to survey the incidence of con- tamination of laryngoscope blades in our operating department and to determine whether the cleaning procedures were adequate. In this institution, different Q 1999 Blackwell Science Ltd Figure 1 The percentage of glottic open- ing (POGO) score for laryngeal grading. The POGO score represents the linear span from the anterior commissure to the interartytenoid notch. ...
Context 3
... cannulae were inserted bilaterally in the 2nd intercostal space in the midclavicular line. A small quantity of air was released from the right side with improvement in the ventilation, oxygenation and haemodynamic parameters. After about 5 min, the patient deteriorated again. A chest X-ray revealed pneumomediastinum and right-sided pneumothorax (Fig. 1). A right-sided intercostal drain was inserted and a signi®cant amount of air was drained. A persistent air leak was noted on the right side with some loss of tidal ...
Similar publications
In patients with subcutaneous neck emphysema, ultrasound images of the internal jugular vein are unclear due to air bubbles. Central venous catheterization can be safely achieved by pushing the accumulated air laterally using an ultrasound probe. image
Background
Cancer indeed represents a significant public health challenge, and unplanned extubation of peripherally inserted central catheter (PICC-UE) is a critical concern in patient safety. Identifying independent risk factors and implementing high-quality assessment tools for early detection in high-risk populations can play a crucial role in r...
PURPOSE: To analyse the effectiveness of percutaneous treatment of central venous obstruction in patients undergoing hemodialysis.
MATERIALS AND METHODS: In 100 patients, 107 central venous strictures [56 subclavian (occlusion:21, stenosis:35) and 51 innominate (occlusion:23, stenosis:28)] were assessed, and 170 percutaneous angioplasty procedures...
to assess the effectiveness of the chlorhexidine antimicrobial dressing in comparison to the gauze and tape dressing in the use of central venous catheters.
a randomized clinical trial was conducted in the intensive care and adult semi intensive care units of a university hospital in the south of Brazil. The subjects were patients using short-term...
The requirement of central venous (CV) port implantation is increasing with the increase in the number of cancer patients and advancement in chemotherapy. In our division, medical oncologists have implanted all CV ports to save time and consultation costs to other departments. Recently, upper arm implantation has become the first choice as a safe a...
Citations
Carotid artery puncture is a common complication of internal jugular vein (IJV) catheterization. However, there are few reports about an aneurysm from the carotid artery that can develop into an occult mediastinal hematoma, leading to airway compression. In this case study, we present the case of a 71-year-old male who experienced an aneurysm and delayed mediastinal hematoma, ultimately resulting in airway compression after right jugular line insertion. Our findings highlight the importance of not only addressing local hematoma formation at the puncture site promptly, but also recognizing the potential for aneurysm extension into the mediastinum and the formation of an occult hematoma, which can lead to airway compression. Additionally, we provide a summary of landmark technique precautions that can help reduce the occurrence of such severe complications.
Artery puncture and hematoma formation are the most common immediate complications during internal jugular vein catheterization. This study was performed to assess whether the bevel-down approach of the puncture needle decreases the incidence of posterior venous wall damage and hematoma formation during internal jugular vein catheterization.
Prospective, randomized, controlled study.
A university-affiliated hospital.
Three hundred thirty-eight patients for scheduled for thoracic surgery requiring central venous catheterization in the right internal jugular vein.
Patients requiring internal jugular vein catheterization were enrolled and randomized to either the bevel-down group (n = 169) or the bevel-up group (n = 169). All patients were placed in the Trendelenburg position with the head turned to the left. After identifying the right internal jugular vein with ultrasound imaging, a double-lumen central venous catheter was inserted using the modified Seldinger technique. Venous entry of the needle was recognized by return of venous blood during needle advance or withdrawal. The internal jugular vein was assessed cross-sectionally and longitudinally after catheterization to identify any complications. A p value of <.05 was considered to be statistically significant.
There was no difference in the incidence of the puncture-on-withdrawal between the two groups (37 of 169 in the bevel-down group and 25 of 169 in the bevel-up group). However, the incidence of posterior hematoma formation was lower in the bevel-down group (six of 169 vs. 17 of 169, p = .031). Additionally, there was less incidence of the posterior hematoma formation associated with puncture-on-withdrawal in the bevel-down group (six of 37 vs. 11 of 25, p = .034).
The bevel-down approach of the right internal jugular vein may decrease the incidence of posterior venous wall damage and hematoma formation compared with the bevel-up approach, which implicates a reduced probability of carotid artery puncture with the bevel-down approach during internal jugular vein catheterization.
