重症监护病房患儿肺部真菌感染的护理

对重症监护病房40例患儿肺部真菌感染采取有效的护理措施。结果40例患儿治疗总有效率为87．5％。提示加强对患儿的病情观察、呼吸道护理,积极观察使用抗生素及抗真菌药物作用及不良反应,做好心理护理和基础护理有助于提高治疗效果。     

重症监护病房患儿肺部真菌感染的护理

对重症监护病房40例患儿肺部真菌感染采取有效的护理措施.结果40例患儿治疗总有效率为87.5%.提示加强对患儿的病情观察、呼吸道护理,积极观察使用抗生素及抗真菌药物作用及不良反应,做好心理护理和基础护理有助于提高治疗效果.     

Transesophageal Echocardiography in Cardiac Surgical Emergencies

The value and utility of transesophageal echocardiography (TEE) in unstable cardiac surgical patients have been assessed; 119 TEE studies were performed and evaluated in the emergency setting. The studies were performed in the cardiac surgical intensive care unit (n = 62) and in the operating room (n = 57). There were 81 men and 38 women with a mean age of 58.2 years. The indications for TEE were as follows: hypotension refractory to conventional treatment (n = 83); prosthetic or native valve dysfunction (n = 25); and suspected aortic dissection (n = 10). TEE provided valuable diagnostic information in 107 patients and was completely normal in 12 patients. Based on these results 22 patients had urgent surgical intervention without further studies. The average time to diagnosis was 11.2 minutes. No significant complications were noted. Our results suggest that TEE is highly diagnostic for most of the abnormalities responsible for hemodynamic instability in the perioperative period and facilitates decision making in cardiac surgical emergencies.     

Transesophageal Echocardiography for the Noncardiac Surgical Patient

Transesophageal echocardiography (TEE) has been established as a very valuable asset for patient monitoring during cardiac surgery. The value of perioperative TEE for patients undergoing noncardiac surgery is less clear. This article reviews the technical aspects of TEE and comments on the potential benefit of using TEE as a monitoring modality apart from cardiac surgery. Based on patient''s comorbidities and/or injury pattern, TEE is a fast and minimally invasive approach to obtain important hemodynamic information, especially useful in a hemodynamically unstable patient. However, certain requirements for the use of the technique are necessary, most important the development of sufficient echocardiographic skills by the anesthesiologists. Indications, skill requirements, and possible complications of the technique are reviewed.