Rev Assoc Med Bras
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Clinical Trial
[Functions of the splenic remnant after subtotal splenectomy for treatment of severe splenic injuries].
To evaluate clinical and laboratory variables in patients submitted to subtotal splenectomy. ⋯ Subtotal splenectomy is a surgical alternative technique for treatment of severe distal injuries of the spleen or when its main vessels are damaged.
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The intramucosal pHi measurement has been studied and evaluated as a minimally invasive method able to offer information about the tissue oxygenation. It's most important advantage is to be a regional not systemic measurement in a place with early changes of blood flow, even in the compensated states of shock, as the gastrointestinal tract. The weaning from mechanical ventilation may cause cardiac output changes as well as redistribution of blood flow to the respiratory muscles. Our aim was to test the hypothesis that the splanchnic blood flow decreases may occur after patients extubation, detected by pHi reduction, and to verify if pHi can be a good predictive index for weaning from mechanical ventilation. ⋯ Our results show pHi decreasing confirming splanchnic blood flow reduction after extubation, however in despite of this circulatory change the patients were weaned from mechanical ventilation and successfully extubated. In this trial the pHi was not a good predictive index. The pHi monitoring seems to be useful and reliable, but it requires further studies to evaluate its sensitivity.
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To analyze the clinical applicability of one-stage treatment of single or multiple sores using the V-Y posterior thigh fasciocutaneous flap. ⋯ We conclude that the posterior fasciocutaneous thigh flap, in V-Y, can be used with safety in the treatment of isolated or multiple ulcers in the gluteal and perineal regions.
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To determine the prevalence of different modes of death and to identify therapeutic limitations in patients admitted to the Pediatric Intensive Care Unit (PICU) at a teaching hospital. ⋯ There was a high prevalence of W/WLS and DNR deaths among ICU patients, thus suggesting therapeutic limitation for them. We were unable to evaluate the level of participation by the medical team and by the family in this decision making process.