Avtor/Urednik		Sinkovič, Andrej
Naslov		Acute respiratory failure from neck hematoma following venous cannulation in a patient receiving streptokinase
Tip		članek
Vir		Respir Care
Vol. in št.		Letnik 42, št. 2
Leto izdaje		1997
Obseg		str. 214-7
Jezik		eng
Abstrakt		I present a case of acute respiratory failure, caused by hematoma in the neck that led to compression of the upper airway and possible cerebral ischemia. A few hours after the patient with acute myocardial infarction had been treated with intravenous system infusion of streptokinase, heparin, and oral acetylsalicylic acid, several attempts were made to gain intravenous access by percutaneous puncture of the internal jugular vein, guided by external anatomic landmarks. A large hematoma developed in the neck, causing acute respiratory failure. The patient's condition was detected during close monitoring, and the patient was treated in time by orotracheal intubation and mecanical ventilation. Intravenous heparin was discontinued, and red blood cells and fresh frozen plasma were transfused. The main goal of thrombolitic therapy - reperfusion with early peak of creatine kinase was not achived. The case suggested that in the first few hours after treatment of acute myocardial infarction with systemic intravenous thrombolytic therapy, the hemostatic defect that develops increases th erisk for bleeding after percutaneous puncture of internal jugular vein. The procedure is safer when it is performed with caution by the most skillful and experienced operator and after prior ultrasonic examination of the neck anatomy in order to avoid several puncture attempts and the increased likelihood of aboudant hemorrhage at the puncture sites. Close morning is essential to identify and treat any potential lifethreatening complication.
Deskriptorji		RESPIRATORY INSUFFICIENCY HEMATOMA NECK MYOCARDIAL INFARCTION INFUSIONS, INTRAVENOUS AGED STREPTOKINASE HEPARIN ASPIRIN JUGULAR VEINS