A 55-year-old man was admitted to our Intensive Care Unit with symptoms and signs of Weil's disease. Respiratory failure developed. Radiological and haemodynamic features were consistent with the adult respiratory distress syndrome. The patient recovered after mechanical ventilation with positive end-expiratory pressure. This case confirms that the adult respiratory distress syndrome may occur in leptospirosis.

Humans↗

PubMed1985

Continuous arteriovenous hemofiltration as an adjunctive therapy for septic shock.

The effects of continuous arteriovenous hemofiltration were studied in septic patients with acute renal failure and gross fluid overload. Hemofiltration was performed for a mean of 7 days per patient (range 1 to 14 days). The mean filtration volume was 3.64 L/day. The mean total ultrafiltration volume per patient was 25.5 L. The patients were hemodynamically stable during hemofiltration, as indicated by measurements of arterial blood pressure, CVP, pulmonary artery pressure, pulmonary artery wedge pressure, and cardiac output. Multiple simultaneous measurements in both serum and ultrafiltrate showed a very close correlation for sodium, potassium, phosphorus, urea and creatinine levels. There was no detectable protein in the ultrafiltrate. The calcium concentration in the ultrafiltrate was relatively low. Finally, antibiotic levels in the ultrafiltrate were almost equal to serum levels. There were no significant complications; in this series of patients hemofiltration was a safe and effective treatment of fluid overload.

Acute Kidney Injury↗

PubMed1984

Intrarenal arteriovenous fistula following percutaneous renal biopsy.

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Adult↗

PubMedDate not supplied

IMVP-16 followed by high dose chemotherapy and autologous bone marrow transplantation as salvage treatment for malignant lymphoma.

Thirty patients with high-grade malignant lymphoma were treated with ifosfamide-VP16213-methotrexate (IMVP-16) combination chemotherapy after failing to respond completely or after relapsing on CHOP-like therapy. Responders to the salvage therapy subsequently were treated with ablative chemotherapy (BCNU, VP16213, Ara-C and melphalan) and autografted. Of these 30 patients 11 were in relapse, 11 were partial responders and eight failed CHOP-like therapy. There were eight complete remissions and 12 partial responses to IMVP-16. These 20 patients were transplanted, together with one nonresponder. Ten of these 21 patients are disease-free survivors 16 to 76 months (median 32) after autografting. There were three treatment-related deaths: one before and two during the autografting procedure. Using one of the best salvage therapy combinations followed by high dose chemotherapy and autografting is feasible. The results of this study suggest that an appreciable number of patients may be cured by this procedure.

Adolescent↗