Examinando por Autor "Tomicic, Vinko"

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    Adsorción extracorpórea de citoquinas en el tratamiento del shock séptico refractario. Casos clínicos
    (Sociedad Medica de Santiago, 2018-06) Rathkamp, Mario; Tomicic, Vinko; Cornejo, Juan; Cruz, Pablo
    If Septic shock (SS) evolves to refractory SS, mortality could reach 90%, despite giving an optimal treatment. Nowadays, extracorporeal devices which adsorb inflammatory cytokines are available, reducing the systemic inflammatory response syndrome. These devices can be used with continuous renal replacement therapy or conventional hemodialysis. We report two diabetic females aged 50 and 58 years, who underwent a total colectomy and amputation of diabetic foot and who developed a SS with high requirements of vasoactive drugs (norepinephrine and adrenaline) to maintain a mean arterial pressure about 60 mmHg. Both were subjected to hemodialysis, connected to a cytokine hemadsorption device. The most important finding was the progressive reduction of vasopressor doses, effect that was observed nine hours after the beginning of the hemadsorption and lasted until its removal at 26 hours. Both patients survived. © 2018, Sociedad Medica de Santiago. All rights reserved.
  • Miniatura
    Ítem
    Lung monitoring with electrical impedance tomography: Technical considerations and clinical applications
    (AME Publishing Company, 2019-07) Tomicic, Vinko; Cornejo, Rodrigo
    In recent years there has been substantial progress in the imaging evaluation of patients with lung disease requiring mechanical ventilatory assistance. This has been demonstrated by the inclusion of pulmonary ultrasound, positron emission tomography, electrical impedance tomography (EIT), and magnetic resonance imaging (MRI). The EIT uses electric current to evaluate the distribution of alternating current conductivity within the thoracic cavity. The advantage of the latter is that it is non-invasive, bedside radiation-free functional imaging modality for continuous monitoring of lung ventilation and perfusion. EIT can detect recruitment or derecruitment, overdistension, variation of poorly ventilated lung units (silent spaces), and pendelluft phenomenon in spontaneously breathing patients. In addition, the regional expiratory time constants have been recently explored. © Journal of Thoracic Disease. All rights reserved.