Abstract:
OBJECTIVE:To describe a case of hepatic subcapsular hematoma causing an acute Budd-Chiari-like syndrome, leading to hepatic compartment syndrome, which combines compression of intrahepatic vessels on CT, acute liver failure, and refractory shock. DESIGN:Case report. SETTING:Surgical ICU of a university teaching hospital. PATIENT:Single case: A 64-year-old man hospitalized for 1 month in the ICU after multiple complications following bypass surgery, under anticoagulation after a recent aortic valve replacement and without a medical history of hepatic disease, underwent a percutaneous cholecystostomy for acute calculous cholecystitis. Fifteen days later, he presented with acute anemia, abdominal tenderness, severe hepatic cytolysis, metabolic acidosis, and hemodynamic dysfunction. CT showed a voluminous subcapsular hematoma compressing the hepatic parenchyma, which appeared ischemic with a flattened right lobar portal vein and vena cava without any visible active bleeding. INTERVENTIONS:Arteriography and evacuation of the hematoma under ultrasound guidance (while managing hemodynamic dysfunction) were preferred to surgery given the patient's instability and surgical history. MEASUREMENTS AND MAIN RESULTS:Evidence of vessels and parenchymal compression with no source of bleeding was found despite removal of the cholecystostomy catheter. Two right sectorial inferior hepatic arteries were embolized. Hematoma was punctured to relieve pressure on hepatic parenchyma, retrieving 300 mL of blood. Unfortunately, liver failure worsened dramatically while patient developed refractory shock and died. CONCLUSIONS:Hepatic compartment syndrome must be suspected when acute liver failure occurs in patients with subcapsular hematoma. Only early management may avoid a fatal outcome or the need for an emergency liver transplantation.
journal_name
Crit Care Medjournal_title
Critical care medicineauthors
Marcaire F,Malavieille F,Pichot-Delahaye V,Floccard B,Rimmelé Tdoi
10.1097/CCM.0000000000001403subject
Has Abstractpub_date
2016-03-01 00:00:00pages
e174-7issue
3eissn
0090-3493issn
1530-0293journal_volume
44pub_type
杂志文章abstract:OBJECTIVE:To determine the impact of adding a month of critical care training in the postgraduate year (PGY)-2 on the critical care skills of PGY-3 residents. DESIGN:Prospective, nonrandomized. SETTING:The internal medicine (IM) residency program of a tertiary care medical center. STUDY SUBJECTS:The study subjects i...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e31819cc170
更新日期:2009-04-01 00:00:00
abstract::Checklists have been recently promulgated as a method to enhance patient safety and improve outcomes for critically ill patients. Specifically, recent work performed by researchers from the Johns Hopkins Medical Institutions has demonstrated that the addition of checklists to usual care in the intensive care unit is a...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/CCM.0b013e31819541f8
更新日期:2009-02-01 00:00:00
abstract:OBJECTIVES:To examine whether niacin attenuates lung inflammation and improves survival during sepsis and to determine whether the beneficial effects of niacin are associated with downregulation of the nuclear factor (NF)-κB pathway. DESIGN:Prospective laboratory study. SETTING:University laboratory. SUBJECTS:Male S...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3181feeae4
更新日期:2011-02-01 00:00:00
abstract:OBJECTIVE:Preoperative intra-aortic balloon pumping (IABP) improves the results of complex coronary surgery. However, its insertion may be harmful or contraindicated in cases of severe and diffuse atherosclerosis of the descending aorta and peripheral arteries. We sought to evaluate the efficacy and safety of transbrac...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000229884.94475.DB
更新日期:2006-08-01 00:00:00
abstract::A patient with brainstem infarction met the clinical criteria for brain death but had persistent EEG activity, complicating our decision to withdraw life support. We evaluated cerebral blood flow with xenon-enhanced computed tomography (Xe/CT), which documented the absence of posterior circulation flow and persistent,...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198705000-00014
更新日期:1987-05-01 00:00:00
abstract:OBJECTIVE:To test the hypothesis that the lectin-like domain of tumor necrosis factor, mimicked by the TIP peptide, can improve lung function after unilateral orthotopic lung isotransplantation. Because of a lack of a specific treatment for ischemia reperfusion-mediated lung injury, accompanied by a disrupted barrier i...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3181cdf725
更新日期:2010-03-01 00:00:00
abstract::Arterial catheterization for blood gas analysis and direct monitoring of blood pressure in infants and children can be attended by a variety of complications, which limit its use to short periods of time. An improved technique, consisting of elimination of stopcocks, the use of a continuous flushing system adapted for...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-197605000-00010
更新日期:1976-05-01 00:00:00
abstract:OBJECTIVE:To investigate the concentrations of reduced and total glutathione in relation to the muscle free amino acid pattern in critically ill patients and matched healthy controls. DESIGN:Prospective case control. SETTING:University hospital intensive care unit (ICU). PATIENTS:Eleven critically ill patients in th...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199701000-00016
更新日期:1997-01-01 00:00:00
abstract:OBJECTIVE:Liquid lung ventilation has been demonstrated to improve cardiorespiratory function after cardiopulmonary bypass. We hypothesized that liquid lung ventilation (LLV) would decrease the pulmonary inflammatory response after cardiopulmonary bypass (CPB). DESIGN:Prospective, randomized, experimental, controlled,...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200104000-00021
更新日期:2001-04-01 00:00:00
abstract:OBJECTIVE:To study the rate of elimination of ethanol after a major burn trauma. DESIGN:Prospective, controlled study. SETTING:National burns unit in a Swedish university hospital. PATIENTS AND SUBJECTS:Eight consecutive patients suffering from 18%-72% total burned surface area and nine healthy male control subjects...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章
doi:10.1097/00003246-199912000-00003
更新日期:1999-12-01 00:00:00
abstract::Computerized gamma scintigraphy revealed a significant (p less than 0.001) rising lung:heart radioactivity ratio, which has been called "slope of injury" or "slope index", with both 99mTechnetium-tagged human serum albumin (99mTc-HSA) and 99mTechnetium-tagged red blood cells (99Tc-RBC) after 0.05 or 0.2 ml/kg iv oleic...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198201000-00008
更新日期:1982-01-01 00:00:00
abstract:OBJECTIVE:Although randomized trials yield less biased estimates of treatment effects than other study designs, unconcealed randomization and lack of blinding can lead to overestimates of the treatment benefit on the order of 15% to 40% on average. In applying the results of clinical trials to patient care, clinicians ...
journal_title:Critical care medicine
pub_type: 杂志文章,meta分析
doi:10.1097/00003246-200207000-00018
更新日期:2002-07-01 00:00:00
abstract:OBJECTIVES:Critical care ultrasonography has become established within ICUs as a diagnostic tool and to guide management strategies and practical procedures. Following an international consensus statement in 2011, various national professional societies and organizations have sought to develop and deliver training prog...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000003626
更新日期:2019-03-01 00:00:00
abstract:OBJECTIVE:To assess whether the delivered nitric oxide (NO) concentration is affected by a change in the ventilatory setting during neonatal mechanical ventilatory support. DESIGN:Prospective, experimental study. SETTING:Laboratory at Nagoya City University Medical School. INTERVENTIONS:This study was performed by u...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200005000-00058
更新日期:2000-05-01 00:00:00
abstract::Perfluorocarbon (PFC) emulsions are promising oxygen-carrying blood supplements for the treatment of shock and in organ preservation for transplantation. We used the isolated, blood-perfused, canine right lower lung lobe (RLL) to determine the effect of a PFC emulsion, Oxypherol (FC-43), upon lung fluid balance and he...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198512000-00006
更新日期:1985-12-01 00:00:00
abstract:OBJECTIVE:To demonstrate the efficacy and safety of an updated version of the nasal "bridle," which is used to prevent the accidental removal of small-bore nasoenteric feeding tubes. DESIGN:A descriptive study. SETTING:Surgical intensive care unit in a tertiary care hospital. PATIENTS:Twenty-six critically ill patie...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199603000-00011
更新日期:1996-03-01 00:00:00
abstract:OBJECTIVE:To study whether noninvasive pressure support ventilation (NIPSV) with helium/oxygen (He/oxygen), which can reduce dyspnea, PaCO2, and work of breathing more than NIPSV with air/oxygen in decompensated chronic obstructive pulmonary disease, could have beneficial consequences on outcome and hospitalization cos...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1097/01.CCM.0000055369.37620.EE
更新日期:2003-03-01 00:00:00
abstract:OBJECTIVES:To assess the specific host responses to systemic endotoxemia and tumor necrosis factor (TNF) activation after abdominal aortic aneurysm surgery by measuring antiendotoxin core antibodies (EndoCab) immunoglobulin (Ig)G and IgM, and soluble p55TNF receptor concentrations. The role of the gut in initiating the...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199709000-00013
更新日期:1997-09-01 00:00:00
abstract::Chest physiotherapy (CPT) is used frequently in the ICU, but there is little available information that quantitates its effect on cardiac or respiratory function. Nineteen mechanically ventilated patients with post-traumatic respiratory failure were studied before, immediately after, and 2 h after CPT was used to mana...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198506000-00009
更新日期:1985-06-01 00:00:00
abstract::To determine whether end-tidal carbon dioxide tension (PETCO2) accurately reflects PaCO2 during high-frequency jet ventilation (HFJV), 43 studies were performed on eight mongrel dogs with normal lungs. During HFJV, minute volume was modified to obtain a range of PaCO2 values from 15.5 to 74.5 torr. When PETCO2 was mea...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198610000-00014
更新日期:1986-10-01 00:00:00
abstract::Simple insertion of a nasogastric (NG) tube was successful in only 52 of 100 anesthetized intubated patients. After the larynx was manually pulled forward, the NG tube was successfully inserted in 33 patients. In the remaining 15 patients, the NG tube was inserted only with the aid of a finger or a laryngoscope used w...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198503000-00013
更新日期:1985-03-01 00:00:00
abstract:OBJECTIVES:To assess in-hospital neurologic (CNS) complications in adult patients undergoing veno-venous extracorporeal membrane oxygenation for respiratory failure. DESIGN:Retrospective analysis of the Extracorporeal Life Support Organization's data registry. SETTING:Data reported to Extracorporeal Life Support Orga...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000002502
更新日期:2017-08-01 00:00:00
abstract::The fractional elimination rate of exogenous fat, and fat-mobilizing lipolysis in relation to plasma catecholamine (CA) levels were studied in seven ventilator-treated ICU patients. Blood levels of CA, triglycerides, cholesterol and free fatty acids (FFA) were also analyzed before and during constant infusion of a soy...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198411000-00006
更新日期:1984-11-01 00:00:00
abstract::Nineteen patients with acute anterior myocardial infarction who were hypertensive (systolic BP greater than or equal to 170 mm Hg and/or diastolic BP greater than or equal to 100 mm Hg) at the time of admission were treated with continuous infusion of sodium nitroprusside (NP). The administration of NP resulted in a s...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198310000-00010
更新日期:1983-10-01 00:00:00
abstract:OBJECTIVE:To investigate the association of collaboration between intensive care unit (ICU) physicians and nurses and patient outcome. DESIGN:Prospective, descriptive, correlational study using self-report instruments. SETTINGS:A community teaching hospital medical ICU, a university teaching hospital surgical ICU, an...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/00003246-199909000-00045
更新日期:1999-09-01 00:00:00
abstract:OBJECTIVE:To review recent advances in the use of transforming growth factor (TGF)-beta in acute lung injury and to apply this knowledge to understanding the pathophysiology of this syndrome. DATA SOURCES AND STUDY SELECTION:Published research and review articles in the English language related to the role of TGF-beta...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/01.CCM.0000057901.92381.75
更新日期:2003-04-01 00:00:00
abstract:OBJECTIVES:Our primary goal was to evaluate the impact on in-hospital mortality rate of adequate empirical antibiotic therapy, after controlling for confounding variables, in a cohort of patients admitted to the intensive care unit (ICU) with sepsis. The impact of adequate empirical antibiotic therapy on early (<3 days...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000098031.24329.10
更新日期:2003-12-01 00:00:00
abstract:OBJECTIVE:The adrenal gland is the endocrine organ most commonly involved in patients infected with human immunodeficiency virus (HIV). It is important to recognize patients with adrenal insufficiency, because this disorder may be fatal if untreated. The incidence of adrenal insufficiency in critically ill HIV-infected...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200206000-00018
更新日期:2002-06-01 00:00:00
abstract::The applicability of continuous arteriovenous hemofiltration (CAVH) for renal replacement therapy was evaluated in three infants and two young children with catastrophic medical and surgical illnesses. In the first four patients, CAVH was used in conjunction with either peritoneal or hemodialysis. In the fifth patient...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198612000-00014
更新日期:1986-12-01 00:00:00
abstract:OBJECTIVES:Critically ill patients routinely receive vancomycin as empiric antibiotic therapy. A continuous infusion administration strategy may be superior to intermittent infusion by minimizing peak concentrations and variability thereby optimizing safety. We performed a systematic review and meta-analysis to investi...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000004326
更新日期:2020-06-01 00:00:00