J Emerg Med
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Review Case Reports
Treatment of portal venous gas embolism with hyperbaric oxygen after accidental ingestion of hydrogen peroxide: a case report and review of the literature.
It is well known that hydrogen peroxide ingestion can cause gas embolism. ⋯ This is a case report of the successful use of hyperbaric oxygen therapy to treat portal venous gas embolism caused by hydrogen peroxide ingestion. Hyperbaric oxygen therapy can be considered for the treatment of symptomatic hydrogen peroxide ingestion.
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The management of septic shock has undergone a significant evolution in the past decade. A number of trials have been published to evaluate the efficacy of low-dose corticosteroid administration in patients with septic shock. ⋯ The evidence suggests that low-dose corticosteroids may reverse shock faster; however, mortality is not improved for the overall population.
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Review Case Reports
Emergency department initiation of cardiopulmonary bypass: a case report and review of the literature.
Out-of-hospital cardiac arrest carries a dismal prognosis. Percutaneous extracorporeal membrane oxygenation (ECMO) has been used with success for in-hospital arrests, and some literature suggests improvement in long-term survival for out-of-hospital arrests as well. ⋯ ECMO is a novel adjunct for patients in cardiac arrest in whom the usual advanced life support techniques have failed.
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Review
Penetrating atherosclerotic ulcerative disease of the aorta: do emergency physicians need to worry?
In recent years, different aortic pathologies have been grouped together and described in terms of a spectrum of disease referred to as Acute Aortic Syndrome (AAS). Overlapping of these conditions has traditionally introduced discrepancy to the understanding of the pathophysiology and definitive care. Penetrating atherosclerotic ulcer (PAU), an ulceration of an atherosclerotic plaque, has been increasingly recognized as the individual cause of the acute aortic pathology. ⋯ The relative rarity of this disease, the difficulties in its detection, and the lack of precise guidelines about its management may result in diagnostic delays. Asymptomatic patients with well-controlled blood pressure are safely managed as outpatients in close consultation with vascular surgery.