Arch Surg Chicago
-
Case Reports
Elective intraoperative intracranial pressure monitoring during laparoscopic cholecystectomy.
The effects of artificial pneumoperitoneum on intracranial pressure have not been clearly defined. Initial animal studies indicate that elevated intra-abdominal pressure might have a deleterious effect on intracranial pressure. ⋯ Initial opening intracranial pressure values were re-established on desufflation of the abdomen. Intracranial pressure monitoring should be considered when planning a laparoscopic procedure on patients with the potential for decreased intracranial compliance.
-
Proteolysis and oxidant injury are important mechanisms of injury in thermal burns. The glycoprotein ulinastatin has antiprotease and free radical-scavenging properties and therefore could be useful in the treatment of these injuries. ⋯ Ulinastatin may have a therapeutic role in treating thermal injuries.
-
To determine which perioperative variables may influence the occurrence of perioperative myocardial infarction (PMI) following vascular surgery. ⋯ beta-Blockade is associated with a decreased incidence of PMI in patients undergoing vascular surgery. Prophylactic perioperative use of beta-blockers may decrease PMI in patients requiring major vascular surgery. A prospective randomized trial of beta-blockers in these patients appears to be warranted.
-
Multicenter Study Comparative Study
High-risk behavior and the public burden for funding the costs of acute injury.
To determine if high-risk behavior is associated with increased injury severity and cost and if public agencies bear a disproportionate burden of that cost. ⋯ High-risk behavior is associated with increased injury severity and cost. Trauma victims exhibiting high-risk behavior more often depend on public agencies to cover the cost of acute injury. Failure to establish and enforce laws and policies designed to reduce or prevent injury may generate enormous trauma care costs, borne to a large extent by public agencies. Further restriction of certain types of high-risk behavior and the institution of "users' fees," taxes, or penalties may be necessary to reduce the disproportionate public agency cost generated by this activity.
-
To audit emergency department thoracotomies from January 1981 to May 1993. ⋯ Emergency department thoracotomies have a definite role in the management of trauma patients. The best results are obtained in patients with penetrating chest injuries.