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Full-Text Articles in Medical Specialties
Not All Free Air In The Nicu Is Necrotizing Enterocolitis., Paul Holtrop, Paras Khandar, Nathan Novotny
Not All Free Air In The Nicu Is Necrotizing Enterocolitis., Paul Holtrop, Paras Khandar, Nathan Novotny
Articles
When a tiny preterm baby in our neonatal intensive care unit (NICU) has an intestinal perforation, it is always necrotizing enterocolitis (NEC), right? Not so fast, my friend. Many of these preterm infants who perforate have free air from spontaneous intestinal perforation (SIP) and not NEC. As it turns out, not all free air in the NICU is NEC. How can you tell the difference and does it matter?
It can be challenging to tell the difference, but SIP tends to occur earlier in life, often within the first week, whereas NEC usually occurs slightly later. One analysis of a …
High Flow Nasal Cannula In The Surgical Patient, Morta Lapkus, Paras Khandhar
High Flow Nasal Cannula In The Surgical Patient, Morta Lapkus, Paras Khandhar
Articles
No matter how much they want it, airway management and the decision to place a surgical patient on a ventilator should not just be for the PICU physicians to decide. The type of ventilation a patient receives can affect the surgical patient both positively and negatively. Could High Flow Nasal Cannula in the surgical patient be beneficial? Imagine a patient with an esophageal anastomosis that is extubated to CPAP. Now imagine the tears that would flow from the surgeon when they discover bilateral pneumothoraces and a blown-out anastomosis. Tragic. Therefore, we must weigh the risks and benefits of intubation versus …
Post-Op Day 1 Fever Is Never Atelectasis, Elizabeth Boudiab, Paras Khandhar
Post-Op Day 1 Fever Is Never Atelectasis, Elizabeth Boudiab, Paras Khandhar
Articles
Postop day 1 fever is never atelectasis. It has been blamed for decades while even the latest editions of surgical textbooks disseminate this myth1. Whilst both fever and atelectasis are extraordinarily common after surgery – occurring in up to 40% and 90% of patients, respectively2 this is NOT the cause on Day 1. It is time that we exonerate this myth.
Postop day 1 fever is never atelectasis, it is due to inflammation and trauma of surgery. The concept that atelectasis was causing fever was derived principally from a study showing that alveolar macrophages sampled from an atelectatic rat lung …