| 1 | Digital radiograph(DR)guided bedside IVC filter placements in patients with intracranial pressure monitors显示文摘Purpose:The purpose of this study is to report a single center experience with portable digital radiographically(DR)guided bedside IVC filters placed in intensive care unit(ICU)patients with high ICP and elevated head of bed(HOB).Materials and methods:A retrospective chart review was conducted on all bedside IVC filters placed from January 1,2010 to September 16,2020.Patients with high ICP and elevated head of bed requirements were included.Charts were reviewed for filter type,common femoral vein(CFV)access,filter location,pre procedure imaging,pre and post filter ICPs,glascow coma scale,number of radiographs taken,and filter removal.ICPs were obtained 1 h prior to procedure and 2 h post procedure and analyzed with a paired T test.Filters were placed by reviewing prior CT scan for IVC size,caval variants,renal and iliac veins and vertebral body landmarks.Then,CFV access was obtained and a Bentson wire was advanced 30-40 cm.A radiograph was used to confirm adequate position of the of the wire.The filter sheath was advanced and serial radiographs were used to position the filter sheath at the final predetermined position below the renal veins and above the iliac bifurcation.The filter was deployed,and a radiograph was obtained to confirm filter positioning.Results:A total of 9 DR guided bedside IVC filters were placed(4 Denali,3 Option Elite,2 Celect).Indications included prophylactic placement(n=8)and acute DVT(n=1).The average patient age was 35.8 years(range:18-56 years)CT abdomen and pelvis was used to assess for the level of renal veins in all patients(n=9).No caval variants were encountered on pre-procedural planning.The average pre,intraprocedural,and post procedure intracranial pressure was 16 mmHg,13 mmHg,and 16 mmHg,respectively.Confirmation of placement after final placement was available in 7 patients(4 DR,2 CT and one fluoroscopic examination).Two non-procedural related deaths occurred.Technical success,defined as successful placement of IVC filter at the predetermined level,was achieved in 100%of patients(n=9).The right CFV was used in most patients(n=7).The left CFV was used for access in two patients due to right CFV thrombus(n=1)and existing right femoral venous central line(n=1).The average number of radiographs taken was 5.8(range 4-9).In all cases,filters were placed below the level of the lowest renal vein(n=9).A comparison of pre,during and post intervention ICP pressures is shown in table,2.No differences between pre and post filter ICP was noted(p=0.77).Three filters were later removed.One minor complication was reported,which was filter tilt(23%)in an Option filter.Conclusion:Bedside IVC filters can be safely placed in patients with head trauma and high ICP who are unable to lay supine using portable DR guidance with a high rate of technical success and minimal complications. | Arthur S.Joseph Jorge E.Lopera | 2021 | Journal of Interventional Medicine2021，4，4： | 3 |
| 4 | 第19章 TOHOKU模式:日本东北大学波浪模式显示文摘TOHOKU模式是一种混合型的,因为它把风浪的单一参数增长方程与涌分量相结合,而且包括涌浪与风浪之间的互换。 19.1 单一参数风浪部分的背景 风浪部分最基本的特征是在成长的风浪中应用一个自相似结构,即由TOba(1972)提出的一个关于成长的风浪的无量纲波高与周期之间的简单的指数定律来表示。 Hs*=BTs*3/2 B=0.062 (19.1)式中Hs*=gHs/ux 2 ,Ts*=gTs/u*是有效波高Hs和有效周期Ts通过重力加速度g和大气的摩擦速度u*标准化后的无量纲形式。这个指数定律是经过多组实验室和海上资料证明的(如Kawai等,1977;Mitsuyasu等,1980)。该定律不仅符合Wilson(1965)和Mut-suyasu等(1971)给出短风区的经验公式,如果除去无量纲风区的话,Wilson等1965年长风区的复杂公式,事实上也符合这个能量定律。图(19.1)给出了一组混合资料的比较情况,3/2次方的能量定律(19.1)可被转换为: | Yoshiaki Toba Sanshiro Kawai Paimpillil S.Joseph | 1989 | 海洋预报1989，6，S1： | 0 |
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