European journal of anaesthesiology
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Comparative Study
Cardiac arrest related to anaesthesia: a prospective survey in France (1978-1982).
This report analyses the rate, predisposing factors, causes and outcome of 119 cardiac arrests related (totally or partially) to anaesthesia which were collected in France by a national prospective survey performed between 1978 and 1982. The overall rate of cardiac arrests occurring during anaesthesia and recovery was 1 per 1665 anaesthetics, resulting in death, before the 24th postoperative hour, in 56% of cases, i.e. 1 per 2900 anaesthetics. ⋯ The last were mainly related to unrecognized postoperative respiratory depression and resulted in the highest mortality. Cardiac arrests were less frequent in private hospitals than in teaching hospitals but the mortality rate was higher.
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Animal experiments and clinical trials have shown that the neonatal respiratory distress syndrome (RDS) can be treated effectively by surfactant replacement via the airways. This treatment facilitates the resorption of fetal pulmonary fluid, promotes uniform air expansion of the lungs, enhances gas exchange, reduces the protein leak across the alveolar epithelium, and prevents the development of bronchiolar epithelial lesions during artificial ventilation. Data from recent animal experiments indicate that surfactant replacement prevents epithelial lung lesions also during high frequency ventilation. Surfactant replacement restores blood gases to normal in adult experimental animals with severe respiratory insufficiency induced by repeated lung lavage, suggesting that this type of treatment might be effective in clinical adult RDS.