Ann Acad Med Singap
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Ann Acad Med Singap · Jul 1999
Review Case ReportsThe use of magnesium sulphate in the intensive care management of an Asian patient with tetanus.
Tetanus, a potentially fatal but largely preventable disease through immunisation, is rare in Singapore. Timely diagnosis and appropriate intensive care management is essential to ensure survival. ⋯ By maintaining serum magnesium at 3 to 4 mmol/l we were able to control sympathetic overactivity by day 6, stop neuromuscular blockade by day 7 and wean off ventilator by day 11. Aminoglycoside-induced hypomagnesemia was also demonstrated, necessitating an increase in magnesium sulphate infusion rate to maintain serum magnesium at therapeutic level.
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Ann Acad Med Singap · Jul 1999
Review Case ReportsRe-expansion pulmonary oedema following one-lung ventilation--a case report.
Acute ipsilateral or bilateral pulmonary oedema following lung re-expansion after pleurocentesis or treatment of pneumothorax is an unusual clinical phenomenon that may have serious consequences. It usually occurs when the chronically collapsed lung is rapidly re-expanded. There are, however, no reported cases of this complication following one-lung ventilation used to facilitate surgery. A report of the occurrence of unilateral re-expansion oedema in a young female undergoing scoliosis correction is described.
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Ann Acad Med Singap · Jul 1999
Comparative StudyRadiological placement of 211 central venous catheters: outcome and complications.
A prospective study of 211 central venous catheters consecutively placed in 186 patients under radiological guidance was conducted over an 18-month period. The majority (64%) of our patients were at risk for acute complications or failure. These risks included bleeding tendency, distorted anatomy, or previous complicated lines and failed "blind" percutaneous attempts. ⋯ The calculated infection rate was 0.25 episodes per 100 catheter days at risk. These results are comparable to those reported in the literature. We conclude that central venous catheterisation using imaging guidance is accurate and safe, and should be the method of choice especially in high-risk patients.