Revista española de anestesiología y reanimación
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Rev Esp Anestesiol Reanim · Jan 1992
Case Reports[Chylothorax. An infrequent complication in surgical exeresis of the esophagus].
We report a case of massive bilateral chylothorax occurring after surgical resection of the esophagus in a patient with esophageal neoplasm. The surgical approach consisted of a thoracotomy and a cervicostomy. The relevance of this case is based on the low incidence of chylothorax after esophageal surgery. ⋯ During the first 24 hours we collected a total volume of 2,500 ml of chyle. The patient was treated with conservative procedures including parenteral nutrition and intravenous reposition of fluids. After 48 hours the total volume of chyle reached 8,500 ml and the patient died.
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Rev Esp Anestesiol Reanim · Jan 1992
Comparative Study Clinical Trial Controlled Clinical Trial[Evaluation of 2 techniques for ventilation support during single-lung ventilation].
In a group of 22 patients undergoing thoracotomy we compared two techniques of ventilatory assistance to the nondependent lung during single lung ventilation. We simultaneously administered a 0.5% FiO2 to the dependent lung. We used a CPAP system with continuous O2 flow limited by an underwater valve at a pressure of +5 cmH2O. ⋯ In 11 out of the 22 patients we firstly applied the lobar CPAP and thereafter the CPAP to the whole lung in order to compare the efficacy of both techniques in the same patient. The PaO2 during single lung ventilation was 86.9 +/- 22.7 mmHg and it increased to 111.1 +/- 37.9 mmHg after lobar CPAP (p less than 0.01) ant to 163.3 +/- 64 mmHg after total lung CPAP ventilation (p less than 0.001). Our results confirm the usefulness of both techniques and they indicate that CPAP to the whole nondependent lung is the most effective.
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The lesions produced by the expansive wave are characteristic of severe injury produced by explosion. This type of injury is being classified as primary lesion. ⋯ In the discussion section we analyze the physical mechanisms leading to this primary lesion and we indicate the organs most commonly affected. We rise general considerations dealing with the management of these patients and we remark the advantages of a coordinated medical attendance policy.
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Rev Esp Anestesiol Reanim · Jan 1992
Comparative Study[Usefulness of pulse oximetry in thoracic surgery].
Saturation of hemoglobin in arterial blood was simultaneously measured by co-oximetry (SaO2) and by pulse oximetry (SpO2) in 228 samples from 42 patients undergoing general anesthesia for thoracic surgery. Data was referred to SaO2 obtained with arterial catheterization. We found a significant correlation (r: 0.949 and p less than 0.001) and the mean differences were 0.77 +/- 1.84. ⋯ Although there was a significant correlation, the method loses reliability and accuracy in patients with hypoxemia. In these patients oximetric values are slightly lower than those obtained with arterial cannulation. We emphasize the clinical usefulness of this technique since it is instantaneous and allowed immediate therapeutic actions.