Acta anaesthesiologica Scandinavica. Supplementum
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Extracorporeal membrane oxygenation (ECMO), originally developed as an artificial replacement for respiratory assistance, is decreasingly used in neonates with respiratory failure. Nevertheless, there is a constant need for this invasive and expensive neonatal treatment modality. ⋯ ECMO remains an important tool in neonatal and pediatric intensive care. However, the number of ECMO therapies was reduced due to respiratory therapeutic progress, but indications and ECMO technology have changed.
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Unlike normal thermoregulatory control, which is largely neuronally mediated, fever is activated by circulating pyrogens. Pyrogens are triggered by either infectious or non-infectious etiologies, all of which may be present in patients undergoing ambulatory surgery. Fever is a regulated elevation in the setpoint temperature for all thermoregulatory responses (warm and cold defenses). ⋯ Wound infections are responsible for many such fevers, although numerous other etiologies contribute. Initial diagnosis should thus focus on determining the etiology of fever. Once that is established, treatment can focus on the specific cause.
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Acta Anaesthesiol Scand Suppl · Jan 1997
Aspects on the cerebral perfusion pressure during therapy of a traumatic head injury.
An actively raised cerebral perfusion pressure by vasopressors is nowadays often advocated during therapy of a post traumatic brain oedema to improve oxygenation of the brain. In this paper we argue that the arterial pressure not uncritically can be raised as the subsequent increase in hydrostatic capillary pressure may favour transcapillary filtration if the blood-brain barrier is opened for solutes. ⋯ An alternative therapeutical concept which both ensures an adequate oxygenation of the brain and controls the intracranial pressure (ICP) is given. In short, it implies active antistress and sedative treatment, adequate fluid therapy with blood and colloids to normal haemoglobine and albumin values, artificial ventilation to normal PaCO2 and PaO2, and this in combination with antihypertensive and catecholamine reducing treatment with alpha 2-agonist and beta 1-antagonist.