Browsing by Author "Regueira, Tomas"
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- ItemINTESTINAL PERFORATION SECONDARY TO BLUNT INGUINAL TRAUMA IN A SOCCER PLAYER: A CASE REPORT(ELSEVIER SCIENCE INC, 2012) Vucetich, Nevenka; Andresen, Max; Hasbun, Pablo; Regueira, Tomas; Ibanez, Luis; Gonzalez, AlejandroBackground: Intestinal perforation caused by blunt trauma to an inguinal hernia is a very uncommon event. Case Report: We present the case of a 55-year old man who suffered trauma to the inguinal area while playing soccer and later developed intense abdominal pain with no categorical signs of peritoneal irritation. Computed tomography scan at arrival showed a right inguinal hernia, with partial protrusion of the ileum, inflammatory changes of the mesenteric fat tissue inside the hernial sac, and free intraperitoneal fluid. Several hours later he developed hypotension and fever. An emergency laparotomy was performed, revealing ileum perforation with peritonitis. Intestinal perforation was repaired without intestinal resection. After surgery, the patient developed severe septic shock with multiple organ failure. He recovered without sequelae and was discharged 3 weeks later. Conclusion: This case emphasizes the potential clinical complications associated with this condition. (C) 2012 Elsevier Inc.
- ItemIntra-abdominal hypertension: Incidence and association with organ dysfunction during early septic shock(W B SAUNDERS CO-ELSEVIER INC, 2008) Regueira, Tomas; Bruhn, Alejandro; Hasbun, Pablo; Aguirre, Marcia; Romero, Carlos; Llanos, Osvaldo; Castro, Ricardo; Bugedo, Guillermo; Hernandez, GlennPurpose: The objective of this article is to study the cumulative incidence of intra-abdominal hypertension (IAH) in septic shock (SS) patients during the first 72 hours of intensive care unit (ICU) admission and to determine if the presence and severity of IAH are associated with sepsis morbidity and mortality.
- ItemMini bronchoalveolar lavage in patients with severe respiratory failure(SOC MEDICA SANTIAGO, 2011) Andresen, Max; Mercado, Marcelo; Zapata, Marcelo; Bustamante, Andrea; Regueira, TomasBackground: To recognize the etiological agent responsible for severe acute respiratory failure (ARF) in patients in mechanical ventilation (MV) is important to determine their treatment and prognosis, and to avoid the excessive use of antibiotics. Mini bronchoalveolar lavage (mini BAL) is a blind, non bronschoscopic procedure, used to obtain samples from the lower respiratory tract from patients on mechanical ventilation (MV). Aim: To assess the feasibility, complications and preliminary results of mini BAL among patients with severe ARF on MV Material and Methods: Prospective study in 17 patients with acute lung injury (ALI) or acute respiratory distess syndrome (ARDS) on MV and with negative conventional microbiological studies. Mini BAL was performed using standardized protocols. Hemodynamic and respiratory parameters where measured before and after the procedure. Samples obtained were sent to quantitative cultures. Results: At baseline: APACHE II score of 22 +/- 6,7, P(a)O(2)/F(i)O(2) ratio was 176.6 +/- 48.6 and the oxygenation index was 9.74 +/- 3.78. All procedures were performed by an ICU resident. Thirty five percent of the procedures had positive cultures and no complications related to the procedures were reported. The procedure lasted an average of 12 minutes and the instilled and rescued volume were 60 ml and 19.6 ml, respectively There were no significant differences between hemodynamic and respiratory variables before and after the procedure. Conclusions: Mini BAL is a safe, fast and easy technique for obtaining samples from the inferior airway in patients with ALI or ARDS on MV (Rev Med Chile 2011; 139: 1292-1297).