Ugeskrift for laeger
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Ugeskrift for laeger · Oct 1996
[Thoracic electric impedance and fluid balance during aortic surgery].
Indices of fluid balance were evaluated during and after aortic surgery in 16 consecutive patients. Thoracic electrical impedance (TI), heart rate (HR), central venous (CVP), pulmonary artery mean (PAMP), pulmonary wedge (PWP) and mean arterial (MAP) pressures as well as fourteen arterial and venous blood gas variables were followed. ⋯ Of the determined variables only TI revealed a meaningful correlation to fluid balance (rho = -0.41; p < 0.01). The results indicate that while central venous and pulmonary artery mean pressures gave the impression of a volume deficit, the positive fluid balance was mirrored by thoracic electrical impedance.
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Ugeskrift for laeger · Oct 1996
[Duchenne muscular dystrophy and anesthesia. A retrospective study].
This retrospective study comprising 37 patients with Duchenne's muscular dystrophy undergoing 56 general anaesthesias shows that 1) no atypical reactions occurred when suxamethonium was omitted, that 2) wherever atypical reactions were observed they were always preceded by the use of halothane and suxamethonium. Haemodynamic instability and intubation difficulties were the major complications encountered. Preoperative optimization and cautious anaesthetic practice avoiding suxamethonium and preferably also avoiding potent inhaled anaesthetics is recommended.
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Centralized trauma care is developing in Denmark, and is producing an increasing interest in the scoring systems used in traumatology. A large number of scoring systems have been developed within the trauma field. After reviewing the literature, we recommend the Revised Trauma Score at strategic intervals during admission, and scoring of the Abbreviated Injury Scale (AIS) according to the 1990 revision at discharge or by autopsy. This will allow calculation of the Injury Severity Scale (ISS) and The Trauma Score--Injury Severity Score (TRISS) making scientific studies in accordance with international standards possible.
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Ugeskrift for laeger · Oct 1996
Case Reports[Angiotensin-converting enzyme inhibitors and anesthesia].
The increasing usage of ACE-inhibitors in the treatment of hypertension and chronic heart failure may increase the incidence of adverse anaesthetic occurrences. Four such cases are described. In two of these cases, the patient reacted with severe hypotension when general anaesthesia was supplemented with epidural bupivacaine. ⋯ Preoperative discontinuation of ACEI-treatment is controversial. We present some of the issues involved. Most authors lean towards continuing ongoing treatment, even though there is firm evidence that this increases the risk of hypotensive episodes due to hypovolaemia, arguing that such events may be predicted and antagonized with fluid therapy.
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Over a three month investigation period, 1199 patients attended a psychiatric emergency-room. The sex ratio was 55.5% male/44.5% female, and the average age of the patients was 43.5 years. ⋯ Only 17% of the alcoholics were admitted to the psychiatric ward. Sixty-one percent of the long-term psychiatric patients were admitted, and only 13% left the emergency-room without any follow-up plan.