Acta anaesthesiologica Belgica
-
Venous air embolism is a major hazard during surgical procedures in the sitting position and is known to cause acute pulmonary edema in animal experiments (6, 7, 17). In man some cases of pulmonary edema immediately following air embolism have been described (10, 15, 16). In this case report we present a patient that developed pulmonary edema which became apparent several hours after the occurrence of air embolism.
-
Acta Anaesthesiol Belg · Jan 1987
ReviewResuscitation and evaluation of victims of blunt multisystem trauma.
The initial management of hemodynamically unstable polytrauma patients can be challenging. Although there are other possible causes of hypotension, such as tension pneumothorax, CNS injury and hemopericardium, in the vast majority of blunt trauma victims shock is due to blood loss. Whereas the diagnosis of circulatory collapse is clearcut, the rapid identification and control of the bleeding source may not be a straightforward matter. ⋯ In concert with respiratory management, other members of the trauma team should secure adequate vascular access, resuscitate the patient and perform a physical examination. Physical findings dictate the order of further diagnostic and therapeutic maneuvers. In unstable patients the potential need for urgent surgical intervention must not be overlooked.
-
Acta Anaesthesiol Belg · Jan 1987
A new patient registration method for intensive care department management.
A new method to describe intensive care department performance is presented. The method is a complication of available administrative and medical data, completed with a severity of illness measure (Acute Physiology And Chronic Health Evaluation, APACHE) and the registration of nursing care intensity. The development of this latter patient stratification system (Intensive Care Activity Score, INCAS) is described. The performance of the method is demonstrated by a study of 200 consecutive admissions.
-
Acta Anaesthesiol Belg · Jan 1987
Randomized Controlled Trial Comparative Study Clinical TrialThe use of midazolam and diazepam for sedation following aorto-coronary bypass surgery.
The new water-soluble benzodiazepine midazolam was compared in a randomized study to diazepam for postoperative sedation in fifty patients following aortocoronary bypass surgery with a sufentanil-anesthesia. Midazolam and diazepam were administered intravenously in repeated doses in conjunction with an opioid infusion (piritramide) from the end of surgery during a twelve-hour study period, patients being artificially ventilated. Midazolam scored better than diazepam for quality of sedation and cardiovascular stability during the period of mechanical ventilation and for respiration during the weaning period and after extubation, although no difference was found in weaning time from artificial ventilation and time of extubation. ⋯ The administration of a loading dose of midazolam 5 mg caused a slight, transient decrease in mean arterial pressure. Midazolam appeared to be a more effective sedative agent than diazepam for short-term administration during mechanical ventilation. No evidence of cumulation and prolonged recovery was seen.