Nederlands tijdschrift voor geneeskunde
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Ned Tijdschr Geneeskd · May 1994
[Limitations to care; evaluation of decision making concerning the death of 104 children in a surgical intensive care unit].
To analyse the decision-making process concerning withholding and withdrawal of life-sustaining treatment in children who died in a paediatric surgical intensive care unit. ⋯ The problems and guidelines suggested from the field of neonatology are applicable not only to newborns with severe congenital anomalies, but also to older children. Evaluation of the decision-making process should not be limited to medical-technical and nursing aspects, but should also include the experiences of the parents and the treatment team.
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Ned Tijdschr Geneeskd · Apr 1994
[Submersion in children; the role of hypothermia and development of adult respiratory distress syndrome].
To evaluate the occurrence of the adult respiratory distress syndrome (ARDS), and of hypothermia as a predictor of outcome in cases of submersion injury in children. ⋯ In our patients with drowning accidents, hypothermia did not appear to provide any protective effect. ARDS, if it occurred, became evident within 6 h after admission.
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To determine how postoperative analgesia care is managed in the Netherlands. ⋯ It is essential to improve postoperative pain control in the Netherlands. Frequent assessments and precise documentation of the intensity of pain and pain relief, on which further therapy can be based, might be a first step in improving postoperative pain control. Optimal postoperative pain management requires the input of equipment and staff.
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Ned Tijdschr Geneeskd · Mar 1994
Case Reports[An abscess as an unexpected complication following epidural anesthesia].
A 58-year-old man underwent surgery for an inguinal hernia. Surgery was performed under epidural anaesthesia. ⋯ Magnetic resonance imaging showed an epidural abscess, which was drained by laminectomy. The patient recovered without neurological sequelae.