Cir Cir
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Randomized Controlled Trial
Usefulness of intravenous heparin to prevent thrombosis of central venous catheter in children.
central venous catheter (CVC) thrombosis in children is a main issue and its prevention with intravenous heparin is still controversial. The aim of this study was to evaluate efficacy of intravenous heparin in preventing CVC thrombosis both clinically and macroscopically. ⋯ heparin infusion at 2 IU/ml is safe and effective in preventing CVC thrombosis in children.
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difficult intubation is defined as the need for more than three attempts for intubation or more than 10 min to accomplish it, a situation that occurs in 1.5-8% of general anesthetic procedures. The aim of this study was to evaluate the predictive factors of difficult airway with known assessment scales. ⋯ it is essential to take the necessary time to assess the airway with the greatest number of criteria predictive of difficult intubation for the person performing the procedure in order to take the necessary steps to face difficulties in this technique.
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intraanesthetic monitoring of high-risk surgery requires the presence of a central catheter usually placed via subclavian puncture following anatomic reference points. This procedure is technically complex, is done blindly, and is not without complications. It has been reported that with the use of ultrasound guidance the puncture site in the vein can be easily identified and the catheter can be safely inserted for monitoring. The purpose of this study is to determine the reproducibility of ultrasound-guided subclavian puncture and report the advantages of the procedure. ⋯ ultrasound-guided subclavian puncture is an alternative to central catheter placement. Time involved is minimal and it ensures adequate placement. There were no complications in this series.
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over time, a significant number of definitions and concepts on quality of care have been identified. This study focuses on quality of care from the perspective of medical patients. ⋯ acknowledgment of the concept of quality of health care provides a starting point to determine the source of errors, malpractice and professional responsibility in order to resolve and prevent them. Conamed offers alternative means for conflict resolution related to physician-patient relationship by means of conciliation and arbitration, favoring patient and family, as well as the medical profession.
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In abdominal sepsis, when the initial surgery fails to control infection, a good choice may be to leave the abdomen open. This is a descriptive study of a series of cases using the vacuum pack system for temporary abdominal closure. ⋯ In our series, early fascial closing was achieved using the vacuum pack at a lower frequency than reported by other authors. Other parameters analyzed were similar to those reported in the literature. The vacuum pack system demonstrated to be effective, although the final selection for temporary abdominal closure will depend on the experience of the institution as well as surgeon preference. The vacuum pack system for temporary abdominal closure of the open abdomen is an effective alternative in patients with abdominal sepsis.