The American surgeon
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The American surgeon · Dec 1990
Left atrial to femoral arterial bypass using the biomedicus pump for operations of the thoracic aorta.
Left atrial to left femoral arterial bypass is an approach to operations of the thoracic aorta dating back to the late 1950s. Since that time, various modifications of the basic bypass circuit have evolved. ⋯ Recently, there have been reports of the use of the biomedicus centrifugal pump in bypass circuits of the thoracic aorta. Our series, as well as the success of others, using this variation of a traditional bypass circuit of the thoracic aorta, establishes the biopump's capability of minimizing inherent complications in the bypass circuit.
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The American surgeon · Dec 1990
The clinical significance of fluid collections in acute pancreatitis.
Computed tomography (CT) displays fluid collections in patients with acute pancreatitis as well defined intra- or extrapancreatic homogeneous areas with low attenuation numbers. We followed, prospectively, the clinical courses of 128 patients who had CT during an episode of acute pancreatitis, to determine the natural history and clinical significance of any fluid collections that developed. Fluid collections were found in 48 (37%) of the 128 patients with pancreatitis. ⋯ Of the 25 patients not requiring operation, five were lost to follow-up, and 19 of the 20 who had spontaneous resolution of their fluid collection(s) had collections less than 6 cm in diameter. The eight patients who required operative pancreatic debridement for abscess or necrosis had multiple small fluid collections. In summary, fluid collections were found in one-third of patients with acute pancreatitis and were often associated with the development of local complications.(ABSTRACT TRUNCATED AT 250 WORDS)
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Emergency center (ER) trauma evaluations often include leukocyte count (LC), serum amylase (SA), electrolytes (EL), and urine analysis. We reviewed records of 100 pediatric ER patients to determine utility of these tests in management of blunt injury. SA was evaluated in 65 patients and ranged from 30-146 U/L (mean 50.6 U/L); 14 patients with normal CT scans had SA from 30-68 U/L (mean 49.1 U/L). ⋯ DA predicted injury with sensitivity 60.0 per cent (specificity 79.2%). DA accurately represented LA results (sensitivity 100%, specificity of 94.5%). DA is a rapid and effective replacement of LA in evaluation of trauma patients in the emergency center.
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The American surgeon · Dec 1990
Comparative StudySurvival after hypertonic saline resuscitation from hemorrhage.
There has been recent increased interest in hypertonic saline resuscitation from shock and hemorrhage. This study was performed to evaluate the survival effects of hypertonic saline resuscitation. Fifty male Sprague-Dawley rats of average weight of 325 grams were anesthetized with halothane. ⋯ Rats were observed 3 days for survival. Survival was significantly lower in the three per cent NaCl group compared with the lactated Ringer's group. It is probable that worsened outcome with three per cent NaCl was associated with intracellular dehydration.