Medicina intensiva
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Cerebral vasospasm remains a leading cause of death and disability in patients with aneurysmal subarachnoid hemorrhage. When vasospasm becomes refractory to maximal medical treatment, endovascular therapies may be considered as an option to increase cerebral blood flow to prevent cerebral infarction. Endovascular techniques include transluminal balloon angioplasty and intra-arterial infusion of vasorelaxants. This article reviews the various endovascular techniques for the treatment of cerebral vasospasm and discusses the mechanisms of action, techniques of administration, clinical results, and limitations of these treatment strategies.
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To study the postoperative factors associated with prolonged mechanical ventilation after cardiac surgery in children. ⋯ Weight less than 7 kg and extrapulmonary complications are the most important factors associated with prolonged mechanical ventilation after cardiac surgery in children.
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To detect donor characteristics related to graft function after orthotopic liver transplantation (OLT). ⋯ We detected no donor characteristics related to graft function or the appearance of complications in recipients during the immediate postoperative period. Donor age > 65 years and documented but appropriately treated bacteremia posed no risk for the viability of the liver after transplantation.
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Treatment with low dose steroids (LDST) in patients with septic shock treated with vasoactive agents has been related to earlier shock reversal. Patients with low baseline cortisol and a blunted response to the corticotropin test are more likely to benefit from LDST, so we compared the immediate hemodynamic response in patients with septic shock who received LDST with that of those who did not receive LDST. ⋯ LDST was not associated to improved 24-hour hemodynamic response, irrespective of the baseline and stimulated cortisol levels.