Air gun pellet: Cardiac penetration and peripheral embolization [Havalı tüfek saçması kardiyak penetrasyon ve periferal embolizasyonu]

PubMed ID: 27598599Use of high-velocity air guns can to lead to serious injuries. Management options of cardiac pellet gun injuries are based on patient stability, and course and location of the pellet. Presently reported is the case of a boy who was shot with an air gun pellet. Following right ventricular entry, the pellet lodged in the left atrium and embolized to the right iliac and femoral artery. Following pellet localization, right ventricular injury was repaired, and the pellet was removed successfully. © 2016 TJTES

Risk factors for prolonged intensive care unit stay after open heart surgery in adults

Objective: Prolonged intensive care unit (ICU) stay prevents the use of ICU equipment by other patients and increases hospital cost. This retrospective study aimed to investigate the risk factors for prolonged ICU stay in patients undergoing open heart surgery. Methods: The medical records of 513 patients who underwent coronary artery bypass grafting and valvular heart surgery were retrospectively evaluated. Patients were divided into two groups based on their ICU stay: groups I (<48 h) and II (?48 h). The effect of patient variables on the ICU stay duration was investigated using logistic regression analysis. Results: The mean age of the patients was 61.5±10 years, and 69% were males. The ICU stay of ?48 h was observed in 20.1% of the patients. Diabetes mellitus and low ejection fraction (pre-operative variables); long aortic cross clamp, cardiopulmonary bypass time and intra-aortic balloon pump requirement (intra-operative variables); arrhythmia, myocardial infarction, renal dysfunction and need for haemodialysis, use of ?2 inotropic agents, infection, sepsis and respiratory complication (post-operative variables) were found to prolong the ICU stay. In multivariate logistic regression analysis, intra-aortic balloon pump requirement, use of ?2 inotropic agents, post-operative myocardial infarction and need for haemodialysis were found to be independent risk factors for prolonged ICU stay (p<0.05). Early mortality was 0.97% (5 patients). Conclusion: Intra-aortic balloon pump requirement, use of ?2 inotropic agents, post-operative myocardial infarction and need for post-operative haemodialysis are independent risk factors for patients undergoing open heart surgery. Selection of methods for protecting the myocardium and renal functions during the intra-operative period would reduce the duration of ICU stay. © 2018, AVES İbrahim KARA. All rights reserved.15.03.2012Ethics Committee Approval: Ethics committee approval was received for this study from the Clinical Research Ethical Committee of Ege University School of Medicine (Date: 06.04.2015, No: 15-3/12). -