Biomedical subjects

D Tuzzo

Publications and source records attributed to D Tuzzo.

3 recordsLinked to original sources

PubMed2000

[Injury of the long thoracic nerve after LRA, which etiology? Clinical case].

The long thoracic nerve supplies the serratus magnus muscle. Its injury causes "winging" of the scapula and functional limitation of the upper limb. Such lesion is mostly due to chronic trauma, occasionally iatrogenic. This case report presents a case of serratus magnus muscle paralysis following an anesthetic block of the brachial plexus performed at the time of a minor orthopedic surgery of the wrist, in a young healthy woman who was a tennis player. The observed lesion seemed to have been caused by the anesthetic technique employed, but, at the same time, it is impossible to rule out, in the etiology of the disease, a role of other predisposing factors, such as the intense sport activity above mentioned, or of concurrent factors, such as an incorrect position in the immediate postoperative period.

Adult↗

PubMed2000

[Percutaneous tracheostomy: technological development].

PDT based on Seldinger's technique is gaining wide acceptance in ICU patients, but the procedure has undergone various modifications during the past thirty years. The ten most known procedures and the target of their innovating content are briefly examined. The incidence of complications desumed from the literature, wide in some cases and limited or absent in others, is also considered. In many cases, the technological modifications of original procedures had two fundamental objectives: to increase it's safety and to reduce the operator-depencence of the procedure. According to the review of the literature (and our experience too) the increasing interest for percutaneous tracheostomy is the justified conclusion of the technological development of some dilatative techniques. With an appropriate training and the continuous endoscopic guidance, it is possible today to perform PDT in critically ill patients of ICU with a very low total complication rate. Even if the comparison between different techniques is not rich enough on prospective randomized studies, the global low rate of hemorrhage complications, of wound infection and of poor cosmetic result are surely demonstrated and probably related to the small skin incision and the tight fitness between tissues and the tracheostomy tube.

Critical Care↗

PubMed1999

[Anesthesia accidents: accidental esophageal intubation].

Accidental oesophageal intubation is a common mistake in inexperienced anaesthetists, but unrecognized oesophageal intubation is fortunately a rare event because, in anaesthetic malpractice claims, it frequently resulted in death or brain damage. The connection of these complications with the lack of experience of the anaesthetist and/or the difficult intubation is not so evident in the literature. The precocious detection of tube dislocation depends on the systematic verification of endotracheal tube position after insertion. The paper describes the clinical and instrumental tests used for detecting tracheal or oesophageal intubation. Clinical signs are often unreliable and, between technical tests, capnography is the most reliable of correct tracheal positioning if waves are regular and repeated; when unavailable, the negative pressure aspiration test is a simple and reliable alternative.

Anesthesia↗