Medicina
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Comparative Study
[Myocardial revascularization combined with mitral valve surgery in case of ischemic mitral valve insufficiency].
The aim of the study was to evaluate the possibility of mitral valve surgery in patients with mitral valve insufficiency and short time outcomes following mitral valve correction combined with coronary artery bypass grafting. ⋯ In cases of coronary artery bypass grafting for patients with moderate and significant mitral insufficiency after myocardial infarction, mitral valve correction must be performed.
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Comparative Study
[Stair climbing test in prediction of postoperative complications after lung cancer surgery].
Preoperative physical state of a patient is very important for adaptation of the patient after lung resections. Purpose of this work is to evaluate an information factor of a stair-climbing test while predicting of postoperative complications after lung cancer surgery. Fifty two patients were examined, who passed lung surgery of different volume. ⋯ Postoperative course was normal for those patients (n=11) who were able to climb five or more flights of stairs. It was noticed that duration of postoperative period has an inverse proportion to a number of the climbed up footsteps. The stair-climbing test is a simple, safe, cheap and informative enough for prediction of postoperative cardiopulmonary complications after lung cancer surgery.
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Between December 1972 and January 2002, 201 patients had replacement of the ascending aorta at Vilnius University Heart Surgery Clinic. 171 of them had aortic valve replacement, too, and 30 patients - without aortic valve correction. Septical complications post operation had 24 (11.94%) patients. Their age ranged from 30 to 73 years (mean 49.4 years). ⋯ Septical complications were not common in patients after ascending aorta replacement. Reoperations were associated with early mortality and satisfactory long-term results. Conservative treatment was not successful.
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Although albumin (A) may be considered an ideal natural colloid, the clinical importance efficacy of A administration in the treatment of critical illness have changed considerably of late years. This article reviews data about the use of A at present. ⋯ There are at the present time no clear indications for A administration. Albumin can be used only as a second-choice infusion solution when other products are not indicated, are contraindicated or have been used up their maximum dose.
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Review Comparative Study
[Procalcitonin: a new infection marker. Its use in intensive care].
In daily routine diagnosis, there are few parameters available to monitor critically ill patients and to control the course of therapy in severe inflammations. There are also few reliable parameters differentiating acute bacterial infection from other types of inflammation. Most of the presently used indicators of the inflammatory response, like body temperature, white cell count, erythrocyte sedimentation rate or C reactive protein are unspecific parameters with changing reliability. ⋯ The incidence of noninfectious systemic inflammatory response syndrome associated with coronary artery bypass surgery and the potential role of several inflammatory parameters as early markers of pulmonary dysfunction induced by cardiopulmonary bypass were investigated. Procalcitonin seems to be appropriate parameter indicating the early development of severe noninfectious systemic inflammatory response syndrome and for predicting pulmonary dysfunction secondary to cardiopulmonary bypass. Hence, the review of the data of different authors may lead to the conclusion that because of wide spectrum of indications procalcitonin concentration can be used for differential diagnosis of bacterial versus non-bacterial inflammation, as monitoring parameter in critically ill patients, the course of disease, treatment control evaluating the effectiveness of antibacterial treatment, for evaluation of high risk patients to see if there are no postoperative bacterial complications as a prognostic indicator.