A middle-aged patient without any noticeable comorbidity has been admitted to our ICU due to respiratory failure caused by COVID-19 and had to be intubated. CT of the thorax was performed five days before our ultrasound examination: The thorax ultrasound (TUS) exam was performed. For a better description of the probe position use …
A 42-year-old patient underwent spondylodesis of Th11-L1 for vertebral fracture. Surgery was performed using a combination of dorsal and ventral left-sided thoracotomy. The patient was transferred to ICU for dyspnea. CT was performed. Atelectasis of upper lobe of the right lung, atelectasis of lower lobe of the left lung and residual pneumothorax ventrally on the …
An old patient with a history of COPD was admitted to the ICU for hypercapnic respiratory failure (pCO2 92 mmHg, pO2 70 mmHg, pH 7.3, BE +18 mmol/l). Level of consciousness improved after non-invasive ventilation was started. Auscultation revealed diffuse rhonchi. No expectoration was present. Chest X-ray performed during admission revealed neither infiltration nor effusion. …
A 45-year-old woman with a history of type-II diabetes (peroral antidiabetics) underwent surgery for splenic abscess. Splenectomy was performed without any complication. The patient was transferred to the standard ward after surgery. Histology confirmed abscess; however, infected intraparenchymal haematoma could not be excluded. Cultivation revealed Propionibacter avidum (typical skin flora commensal). The patient reported therapy …
An 82-year-old patient underwent elective surgery (right hemicolectomy) due to the adenocarcinoma of the ascending colon. On the 5th day, the patient vomited intestinal content. She was admitted to the ICU for respiratory insufficiency several hours later. The patient had to be intubated (after short non-invasive ventilation). Shock developed during mechanical ventilation and levels of …
A patient with difficult weaning from mechanical ventilation having persisted significant elevation of inflammatory markers. Patient´s history encompasses resection of the lower lobe of the right lung for adenocarcinoma complicated by empyema of right thoracic cavity one year ago, chronic cor pulmonale (COPD), chronic ischemic heart disease. Nosocomial bronchopneumonia was present on the right side …
An 80-year-old patient underwent abdominal surgery (part of the small intestine was resected due to ischemia). Dyspnea developed on the 3rd day after extubation. Tachypnea with RR of about 30/minute. Physiological blood gas exchange. No antibiotic therapy. Lab tests revealed decreasing levels of inflammatory markers. No metabolic acidosis was present. We started looking for the …
An 82-year-old patient underwent surgery for big retrosternal goitre. The jugular approach was used. Patient´s medical history had been minimal so far. Bleeding into surgical wound occurred shortly after surgery. Prompt re-intubation and surgical revision were necessary. A short period of haemodynamic instability occurred during surgical revision. Blood loss of 500 ml was compensated via …
An 82-year-old patient was admitted to hospital for progressively worsening dyspnea for 14 days. Huge fluidothorax on the left side was revealed at emergency. A puncture evacuated 1500 ml of significantly haemorrhagic effusion (haemoglobin 35 g/l, haematocrit 0.15). Patient´s haemodynamics was stable. Dyspnea improved after the puncture. On the next day, thoracic drainage was established. …
rAn 85-year-old patient was admitted to the hospital for worsening of her health condition and weakness. She medicated 10 mg of prednisolone three times per day for ulcerative colitis. She presented neither with dyspnea nor with pain during admission. She was well-oriented to time and space. No fever was present. She was not able to …
