Erector spinae plane block facilitating rapid weaning in an anticoagulated V-V ECMO patient with chest trauma.

IntroductionWe report the successful use of erector spinae (ESP) plane block in the management of a patient with severe respiratory failure secondary to chest trauma requiring invasive ventilation and Veno-venous extracorporeal membrane oxygenation (V-V ECMO).Case reportA 64-year-old man with flail chest and severe respiratory failure required V-V ECMO. An ESP plane block on day 3 enabled extubation, mobilisation, and secretion clearance, leading to ECMO weaning after six days and discharge 18 days post-injury.

A survey on the practices and capabilities in the management of respiratory failure in South East England.

Introduction: The variability of acute respiratory distress syndrome management may affect the referral practice to severe respiratory failure centres. We described the management of acute respiratory distress syndrome in our catchment area.

Methods: An electronic survey was administered to 42 intensive care units in South-East England.

Levosimendan: a retrospective single-center case series.

Purpose: The purpose of this study is to describe the effect of levosimendan (without loading dose) on hemodynamics, inotropes/vasopressors, and mortality in acute heart failure (AHF).

Materials And Methods: Patients who received levosimendan for AHF were analyzed. Levosimendan dose, hemodynamic data, inotrope/vasopressor requirements, and fluid balance before commencement, at conclusion of, and 24 hours after levosimendan were collected.

Cerebral infarction following thrombolysis for massive pulmonary embolism.

A 29-year-old male developed a fatal stroke 6 h after successful thrombolysis for massive pulmonary embolism. Autopsy showed thrombus protruding through a patent foramen ovale (PFO). A strand of thrombus extended from the aortic arch into the left common carotid artery.