Ugeskrift for laeger
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Ugeskrift for laeger · Apr 2008
Letter Historical Article[Junior physicians in emergency service--then].
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Limited evidence on perioperative fluid management has resulted in large variability in administered fluid regimens with unknown implications for the outcome. Present data indicate fluid overload and hypovolemia to be equally deleterious, and individualized fluid therapy may be recommended in high-risk patients undergoing major elective surgery. Future studies should be procedure-specific and with standardized perioperative management with increased focus on the postoperative period.
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Esophageal perforation can within hours result in seriously-ill patients with a high risk of complications. The array of treatment options is many and minimal invasive methods are emerging. ⋯ The potential applications of thoracoscopic surgery as a minimal invasive treatment for esophageal perforations are discussed, as well as the advantages of a combination of videothorascopic drainage and placement of a covered expandable stent. This combination must be evaluated in future studies.