Lancet
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Comparative Study
Hypophosphataemia: A complication of "innocuous dextrose-saline".
Plasma and urinary phosphate levels were studied before and after operation in 13 patients undergoing uncomplicated major surgery. The maintenance intravenous fluid in six patients was 0.9% saline and in the other seven patients it was 4% dextrose with 0.18% saline. Although the plasma-phosphate fell in both groups, reaching minimum on the second postoperative day and then returning towards normal, it was significantly lower in the group receiving dextrose on the second, third, and fourth postoperative days when the levels were below the normal range. It is suggested that when dextrose-saline solutions are indicated in postoperative patients the addition of phosphate to the solution should be considered.
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The survival-rate in 75 of 631 patients with cardiac arrest in whom resuscitation was started outside hospital by lay people was 36%. Only 8% survived when attempts at resuscitation were delayed until the arrival of an ambulance team which included an anaesthetist and a specially trained nurse. These data show the importance of anoxia-time (time from cessation of circulation to initiation of resuscitation) to the chances of survival after resuscitation) to the chances of survival after resuscitation, and support the idea that lay people should be taught and encourage to perform cardiopulmonary resuscitation.