Quote:
Originally Posted by Red Flag 1
Great case Doc Dutch!!!
Silly question, but I have to ask; did you place him prone in the OR or do this in a lateral postion? Also, did he require PEEP post-op in the unit?
Thanks again!!
RF 1
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Great question. In an elective case I would have strongly considered the prone position, say for a popliteal aneurysm, however, as I had suspected that there was a venous injury, I knew or suspected that I was going to have to harvest vein. As the injured side's deep system was already compromised that really only meant he would be living off of his superficial system (saphenous vein) to drain the blood from his distal extremity and I did not want that system compromised. The result of the deep and superficial systems being compromised at the same time can be debilitating and life-long swelling of that lower extremity. So, I did the case supine to get access to the opposite uninjured lower extremity (saphenous vein). Thank goodness we did that as we needed that vein for the patch angioplasty of the artery.
As for the PEEP (positive end expiratory pressure) on the ventilator, yes, we started out I believe at 5 in the OR and went up to 8 to 10 post-op in the ICU. We subsequently weaned him down back to 5 as his body and kidneys diuresed the fluids.
Dutch