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I Garutti

Publications and source records attributed to I Garutti.

23 records · Page 2Linked to original sources
PubMedDate not supplied

[Improved oxygenation with nitric oxide treatment for hepatopulmonary syndrome after a liver transplant].

A 37-year-old man with cirrhosis of the liver hospitalized for orthotopic liver transplant (OLT) was found to have hepatopulmonary syndrome (HPS) during routine presurgical assessment. No problems with oxygenation developed during surgery. In the early recovery period, however, hypoxemia was observed to be uncorrected in spite of gradual normalization of liver function tests. OLT sometimes corrects HPS and, therefore, hypoxemia. However, significant decreases in oxygenation during recovery have been reported to affect patient morbidity and mortality. We therefore started low-dose nitric oxide (NO) inhalation once other possible causes of hypoxemia had been ruled out. Oxygenation improved, allowing tubes to be removed. Seven months after OLT, home oxygen therapy was still required to treat basal hypoxemia. HPS persisted, as confirmed by echocardiogram. Inhaled NO contributed to maintenance of adequate oxygenation during the early postoperative period, as essential for long-term survival in patients with HPS who undergo OLT.

Adult↗
PubMedDate not supplied

[Internal jugular vein catheterization performed by resident and staff physicians].

OBJECTIVES: To analyse complications in the catheterization of the internal jugular vein using the Boulanger technique and to establish a rating of difficulty and risk when the procedure is carried out by physicians in training. MATERIAL AND METHODS: This was a prospective study of 296 internal jugular vein (IJV) catheterizations by the Boulanger technique carried out by physicians in training (group R2 and group R3-4) or by departmental staff physicians (group staff). Time taken for venous catheterization, rate of success and complications were recorded for each physician performing the procedure. RESULTS: The complication most often observed (11.4%) was puncture of the carotid artery (14.3% group R2, 10% group R3-4 and 8.2% staff), followed by arrhythmia upon insertion of the metal guide (1.6%). There were no instances of pneumothorax or hemothorax, nor any other of the early complications considered infrequent. Success ranged from 68.8% for group R2 to 85.7% for staff. Mean time used in group R2 was 238.7 seconds, while for staff it was 118.3 seconds. CONCLUSION: We suggest that the Boulanger technique for catheterization of the internal jugular vein is a good one and is not particularly hazardous when performed by resident physicians in training.

Adolescent↗
PubMedDate not supplied

[Intracavitary electrocardiography. A useful method for checking the correct localization of central venous catheters].

A placement technique for central venous catheters (CVC) using the intracavitary electrocardiography (ICECG) as well as three different connection systems of the CVC to the electrocardiographic monitor are described. The aim of the present study was to evaluate the correct placement of the CVC by this technique with posterior radiologic confirmation being carried out. The study was undertaken in 30 patients connecting a CVC to a negative electrode of the standard lead II and the positive to the left leg. The CVC was advanced and the changes in the morphology of the "P" wave as it passed along the superior vena cava (SVC) to the right auricle (RA) were observed. In 28 of the 30 patients (93.3%) a biphasic "P" wave (right auricle) was achieved with the CVC being thereafter withdrawn until the SVC (this location was radiologically confirmed posteriorly). In 2 patients (6.6%) a biphasic "P" wave was not obtained and an abnormal position of the CVC was radiologically demonstrated at surgery (one in the ipsilateral subclavian vein and the other had a ring within the right subclavian vein impeding progression). The mean time used in the performance of this technique was 220 +/- 40 s. It is concluded that intracavitary electrocardiography is a simple, easy to learn and perform technique which does not delay surgical procedure and it is a reliable method for placing the end of the CVC.

Catheterization, Central Venous↗