Middle East journal of anaesthesiology
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Middle East J Anaesthesiol · Oct 1989
Comparative StudyMortality in the surgical intensive care unit--the role of sepsis and organ failure.
Study of admissions to the surgical intensive care unit (SICU) at King Khalid University Hospital in Riyadh was carried out from 1982 to 1987. There were 1149 surgical admissions, of whom 96 patients died (mortality rate 8.3%). Eighty-six patients died of multisystem and organ failure (MSOF). ⋯ Gram-negative bacilli and gram-positive cocci were the predominant organisms with only two positive anaerobic cultures. In this study the risk for developing sepsis starts at the age of 50, otherwise our data confirm previous studies on the influence of sepsis and MSOF on mortality in SICU. Recommendations for future improvement in patient's care and investment in antibiotic research are made.
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Middle East J Anaesthesiol · Oct 1989
Comparative StudyModified sampling connection for sidestream end tidal CO2 monitoring during pediatric anesthesia.
A modification to the sampling connection of Ohmeda 5200 CO2 monitor was done to abolish the increase in apparatus dead space induced by the patient circuit adapter. The modified and the original sampling connections [MSC & OSC] were compared regarding their effects on end tidal CO2 (PECO2), during surgery in 12 anesthetized spontaneously breathing infants and children. The MSC maintained normal PECO2, while it was significantly higher using the OSC.
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Clinical monitoring of neuromuscular function can be accomplished by either measuring the evoked mechanical or EMG response of a skeletal muscle via an accessible motor nerve. The pattern of motor nerve stimulation varies from supramaximal single repeated stimuli at a specified frequency to tetanic stimulation, posttetanic single stimuli at the pretetanic frequency, and train-of-four stimuli at 2 Hz. The response to relaxants is unpredictable in the population at large and more so in pathologic states. ⋯ The train-of-four technique of measurement has proved to be valuable not only as a reliable clinical tool to measure the response to relaxants and monitoring recovery, but also as a research tool for studies of old and new neuromuscular blocking drugs. Evoked responses and clinical criteria for adequate recovery from muscle relaxants should complement each other. The more criteria fulfilled, the better and safer the conclusion that the patient has recovered from clinical neuromuscular blockade.