Medicina
-
Postoperative lung injury is one of the most frequent complications in cardiac surgery that has a significant impact on health care expenditures and largely has been believed to result from the use of cardiopulmonary bypass. Cardiopulmonary bypass induces the whole body inflammatory response leading to postoperative lung dysfunction. Pulmonary complications after these operations take the first place in morbidity and mortality rates. ⋯ Therefore, the prevention of such alterations is an urgent problem worldwide. Still it is not known what is the cause of pulmonary alterations, as well as there are no means to prevent them. In our paper we review the international studies in order to present worldwide practice of prevention of pulmonary alterations using various methods of mechanical lung ventilation.
-
Randomized Controlled Trial Comparative Study Clinical Trial
[Intercostal nerve blockade with alcohol during operation for postthoracotomy pain].
Purpose of this study was to evaluate the effectiveness of intraoperative intercostal nerve blockade with alcohol in addition to epidural analgesia with morphine for control of postthoracotomy pain syndrome. ⋯ Additional intraoperative intercostal nerve blockade with alcohol provides an additional benefit for postthoracotomy pain relief, especially for at least one month following the thoracotomy.
-
Comparative Study
[Features of the spinal cord injury in distractive flexion and compressive extension cervical spine trauma].
1) to assess neurological status in patients with distractive flexion and compressive extension cervical spine injuries; 2) to determine the relationship between neurological recovery and the patterns of cervical spine injuries. ⋯ Neurological status of the patients with distractive flexion and compressive extension cervical spine injuries did not differ. The relationship between neurological recovery and the patterns of cervical spine injuries did not exist.
-
Randomized Controlled Trial Clinical Trial
[Bupivacaine for continuous interscalene brachial plexus analgesia after shoulder surgery].
This study evaluates clinical efficacy of continuous interscalene brachial plexus block with bupivacaine 0.15% for postoperative analgesia after shoulder surgery. ⋯ Continuous interscalene brachial plexus analgesia is a reliable and effective method of providing postoperative pain relief after shoulder surgery and is superior to the systemic analgesia.
-
It has been estimated that 50-70% of cardiac arrests are caused by acute myocardial infarction or fulminant pulmonary embolism. Thrombolysis could be the treatment of choice during cardiopulmonary resuscitation given its ability to treat the underlying cause of the condition. Traditionally thrombolysis during cardiopulmonary resuscitation has been contraindicated because of risk of life-threatening bleeding complications. ⋯ This condition causes inadequate reperfusion of the brain. Experimental studies demonstrate that besides dissolving coronary thrombus or pulmonary emboli, thrombolytic therapy improves microcirculatory flow resulting in better reperfusion of the brain which translates into better neurological outcome after resuscitation. Should the currently ongoing "Thrombolysis In Cardiac Arrest - TROICA Study" confirm the results of the earlier trials, thrombolytic therapy may soon become part of the resuscitation guidelines.