Der Anaesthesist
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The customary use of standardized regimens for heparin anticoagulation and its neutralization by protamine in cardiopulmonary bypass may result in gross over- or underdosage of either substance with resulting clinical problems. Heparin and protamine doses, postoperative blood loss during the first 20 h and the need for bank blood in a group of 100 patients following a fixed heparin-protamine protocol were compared with another group of 106 cases with ACT-guided heparin and protamine dosage. ⋯ The mean postoperative blood loss in the ACT-cases was 4.54 ml/kg/20h, 2.29 ml respectively 33.5% less than that of control group. The demand for bank blood in the ACT-group was 1.97 units opposed to 5.12 units in the standardized regimen group.
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Hearing loss after spinal anaesthesia is very seldom reported in the literature. After having seen such a case we studied prospectively 100 patients with urological operations under spinal anaesthesia. We found 3 patients having a typical picture of a transient hearing loss in the low frequency range (30 dB). This disturbance was reversible in short time without special therapy.
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Case Reports
[Hemothorax caused by injury of the 1st intercostal artery following trial puncture of the subclavian vein].
This article reports the case of a patient who sustained an injury of the intercostal artery after a vena subclavia aspiration with extensive haemothorax. After thoracotomy, haemostatic treatment, respiratory therapy, intensive care and a prolonged hospital stay the female patient was discharged with a clean bill of health.