Acta anaesthesiologica Belgica
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Malignant hyperthermia is now recognized as a distinct entity in anesthetic practice and can be considered as a pharmacogenetic disease of obscure etiology occuring in man and pigs with a dominant inheritance. A close association with myopathy has been noted. Commonly used muscle relaxants or anesthetic drugs can act as triggering agents in genetically susceptible patients, who develop a real hypermetabolic state, characterized by a rapid rise in body temperature, muscular rigidity, tachycardia and tachypnoea, cyanosis and severe respiratory and metabolic acidosis, the lethality being about 60%. ⋯ A regime of treatment is suggested, based on current concepts of the pathogenesis. It consists in establishing effective and rapid cooling, reversal of tissue hypoxia and correction of respiratory and metabolic acidosis and hyperkalemia. Specific therapy with dantrolene sodium may prove to be an answer to this serious problem.
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Acta Anaesthesiol Belg · Jan 1978
Comparative StudyMonitoring of cardiac output by pulse contour method.
A pulse contour method for cardiac output determination was evaluated in sixteen cardiac surgery patients. Stroke volume was derived from the aortic pressure waveform by means of a formula developed by Wesseling and was calculated with an in-built computer (Philips cardiac output module). ⋯ The overall comparison of data (71 simultaneous measurements) yielded a correlation coefficient of 0.78 (regression y = 0.81 x + 1.07 liter) (p less than 0.001). Advantages and disadvantages of the pulse contour method are discussed.
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Intensive Medicine is always associated with the problem of handling the mass and assuring the quality of information on vital signs, fluid and blood balance, laboratory data, physiological calculations, etc., required in patient care. A computer based monitoring system for intensive care was introduced in 1973 at the Academic Hospital in Leuven. The basic software was developed at the Peter Bent Brigham Hospital of the Harvard Medical School and the medical division of the Hewlett Packard Company; the computer used was a H. ⋯ G.-analysis is being developed. The same computer serves the remotely located medical and coronary care units and one bed in the emergency department. An assessment of computer assistance in intensive therapy, on nursing labor and on quality of patient care is made.
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Acta Anaesthesiol Belg · Jan 1978
Case ReportsTwo cases of burns caused by misuse of coagulation unit and monitoring.
Two cases of severe burns with monitoring apparatus are described. In a female patient of 45 years, a severe third degree burn occurred by misuse of coagulation apparatus (inversion of the poles of an older Bovie apparatus), in the presence of a non-floating ECG monitoring device. ⋯ A twin-wired disposable earth plate was placed just beneath the indifferent ECG electrode on the leg. A burning current was established between the Bovie coagulation unit and the monitor.
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Acta Anaesthesiol Belg · Jan 1977
Total intravenous anesthesia with etomidate. III. Some observations in adults.
An investigation was undertaken to determine the dosage of etomidate required to maintain sleep in adults undergoing surgery under regional local anesthesia. Premedication of diazepam 10 mg and atropine 0.5 mg was given, and sleep was induced and maintained by intermittent intravenous injections of etomidate 0.1/mg/kg, given whenever the patient would open his eyes on request. ⋯ It is considered unlikely that etomidate will prove to be the hypnotic of choice for a totally intravenous anesthetic technique in adults because of the high incidence of myoclonia after prolonged administration. In several patients uncontrollable muscle movements persisted for many minutes after complete recovery of consciousness.