Medicina
-
Comparative Study
[Prognostication of acute intraoperative bleeding in children with burn wounds undergoing tangential necrectomy and auto-dermatoplasty].
The aim of this study was to estimate the blood loss of children undergoing tangential necrectomies and skin grafting by using gravimetric methods. Also we had to estimate the influence of age upon the quantity of blood loss. We examined 50 cases. ⋯ The age of children does not influence the intensiveness of bleeding per square measure site of the necrectomy and harvesting area. The blood loss is a constant quantity and is equal to 0.47 +/- 0.1 ml/cm2. The blood loss that takes place from one percent of the necrectomy and harvesting areas is approximately equal to 2.05% of the circulating blood volume.
-
Comparative Study
[Patient-controlled analgesia in the treatment of postoperative pain in children and adolescents].
We aimed to evaluate the efficacy, morphine requirements and side effects in patients managed with patient-controlled analgesia postoperatively. ⋯ In the majority of patients patient-controlled analgesia was effective and used doses of morphine were low. Though nausea/vomiting was the most common side effect, decreased respiratory rate was observed in some patients. Regular patient evaluation for vital signs and side effects is recommended.
-
Case Reports Comparative Study
[Simultaneous myocardial revascularization and abdominal aortic aneurysm repair (report of a fatal case)].
Patients with coronary disease associated with abdominal aortic aneurysm or aortoiliac occlusive disease often raise problems of operative strategy. In particular, the order in which these lesions should be treated is a frequent source of controversy. Our approach for the past two years has been a combined myocardial revascularization with abdominal aortic reconstruction in patients with both lesions. ⋯ We report here the fatal case of combined coronary artery bypass grafting and abdominal aortic aneurysm repair. Partial heparinization and operation without extracorporeal circulation caused acute thrombosis of abdominal aortic aneurysm and femoral arteries. Our first experience advocates using total heparinisation and cardiopulmonary bypass for combined cardiac-aortic procedures.
-
Amniotic fluid embolism is a rare obstetric emergency in which amniotic fluid, fetal cells, hair, or other debris enters the maternal circulation. Amniotic fluid embolism is an incompletely understood obstetric complication unique to pregnancy presenting with the acute onset of hypoxia, hypotension and severe coagulopathy. ⋯ It cannot be predicted nor prevented. The epidemiology of amniotic fluid embolism, frequency, pathophysiology, clinical presentation, histologic findings, diagnosis, differential diagnosis, possible treatment, mortality rate, neonatal survival are discussed in this review article.
-
During 1987-2000, in Clinic of Thoracic Surgery, Kaunas Medical University Hospital 30 patients with cardiac injuries and foreign bodies in the heart were treated. Average age of patients--37 years. ⋯ Two patients had foreign bodies in the heart (one--needles, one--bullet). We present two rare cases of foreign bodies in the heart.