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Case Report
- Neurosurgery
- A point-of-care evaluation after visual loss following paraclinoid aneurysm repair: the role of sonographic and pupillometer assessment
- Giacomo Bertolini, Ernesto Migliorino, Diego Mazzatenta, Carlo Bortolotti, Raffaele Aspide
- Received January 9, 2022 Accepted March 17, 2022 Published online July 5, 2022
- DOI: https://doi.org/10.4266/acc.2022.00045 [Epub ahead of print]
- 2,134 View
- 29 Download
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Abstract
PDF - Visual complications represent common deficits following surgical or endovascular repair of paraclinoid aneurysms. Different etiologies should be investigated to prevent devastating consequences. Herein we present a point-of-care evaluation to investigate sudden visual loss after coiling of a paraclinoid aneurysms. A 20-year-old male were admitted for a sudden headache. Head computed tomography showed a subarachnoid hemorrhage and subsequent angiography revealed a 9-mm left supraclinoid aneurysm of the internal carotid artery treated with endovascular coil embolization. Thirty minutes after intensive care unit admission the patient reported a left amaurosis. To exclude secondary etiologies an immediate evaluation with point-of-care devices (color-doppler and B-mode ultrasound and automated pupillometry) were performed. Sonographic evaluations were negative for ischemic/thrombotic events and neurologic pupil index within physiological ranges provide evidence of third cranial nerve responsiveness. The symptomatology resolved progressively over 120 minutes with low-dose steroid therapy, 30° head-of-bed elevation and blood pressure management. Visual deficits can occur after endovascular procedure and should be investigated. Suspected visual loss is a neurological emergency that deserve a prompt evaluation. Ultrasound and automated pupillometry have proved to be an effective, rapid, reliable and non-invasive combination for a clinical decision-making strategy in the management of post-procedural acute visual deficits.
Original Article
- Comparison of Conventional Chiron 348 pH/blood Gas/electrolytes Analyzer and i-STAT Portable Clinical Analyzer
- Dong Suk Chung, Jong Bun Kim, Sie Hyun You
- Korean J Crit Care Med. 2000;15(1):35-40.
- 1,689 View
- 16 Download
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Abstract
PDF
- BACKGROUND
The development of so-called "Point-of-care" (POC) devices for blood or urine analysis has resulted in many systems that are widely used at home or at the bedside. We evaluated the performance of the I-STAT portable clinical analyzer for measuring blood gases (pH, PCO2, PO2) and whole blood electrolytes (sodium, potassium and ionized calcium) with reference to a conventional blood gas analyzer (Chiron 348 pH/ blood gas/electrolytes).
METHODS
Thirty samples from the arterial blood were simultaneously analyzed with I-STAT system and with Chiron 348 pH/blood gas/ electrolytes analyzer. Differences between results of two methods were analyzed by paired t-test (p<0.05).
RESULTS
PO2, PCO2 and Na measured with I-STAT system and Chiron 348 PH/ blood gas/ electrolytes analyzer showed no significant differences. pH, calculated HCO3, K and Ca measured by two methods showed significant difference, but observed differences would not affect clinical decisions except ionized calcium.
CONCLUSIONS
This study shows that blood gas and electrolyte analysis using the I-STAT portable device is comparable with that performed by a conventional Chiron 348 pH/blood gas/ electrolytes analyzer except ionized calcium.
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