Revista médica de Chile
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Revista médica de Chile · Oct 1995
Review Case Reports[Extracorporeal membrane oxygenation in adult respiratory distress syndrome. Experience in 2 patients].
We report two female patients with adult respiratory distress syndrome and severe respiratory failure in whom extracorporeal membrane oxygenation was used. Its indication was due to a bad response to conventional treatment with mechanical ventilation and high levels of positive end expiratory pressure. A 2.0 or 2.2 m2 membrane oxygenator in a veno-venous circuit with systemic anticoagulation was used, maintaining mechanical ventilation. ⋯ The second patient was connected to the procedure after three weeks of respiratory distress syndrome and no increase in arterial oxygenation was achieved. The patient died due to an intracranial hemorrhage, probably hastened by systemic anticoagulation. The real benefits of extracorporeal membrane oxygenation are not defined yet.
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Revista médica de Chile · Sep 1995
Case Reports[False high levels glycosylated hemoglobin in 2 diabetic patients with persistence of fetal hemoglobin].
Two diabetic patients with unusual high levels of glycosylated hemoglobin measured by ion exchange chromatography are described. Further studies revealed a persistence of fetal hemoglobin in both cases. ⋯ These cases may be overtreated with risk of hypoglycemia. Patients with inappropriate levels of glycosylated hemoglobin should be investigated for hemoglobinopathies.
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Revista médica de Chile · May 1995
Randomized Controlled Trial Comparative Study Clinical Trial[Morphine infusion for postoperative pain management in patients who have undergone upper abdominal surgery].
We compared the efficacy and side effects of postoperative continuous infusions versus intermittent intravenous on-demand morphine, with or without the addition of clonixin. Eighty five healthy patients, aged 18 to 65 years, scheduled for elective cholecystectomy, were prospectively randomized: Group 1 (n = 22) received morphine 2.5 mg i.v. on-demand; group 2 (n = 22) received a clonixin 400 mg/day i.v. infusion; group 3 (n = 19) a morphine 0.4 mg/kg/day i.v. infusion; and group 4 (n = 22) received a clonixin 400 mg/day plus a morphine 0.4 mg/kg/day i.v. infusion. Groups 2, 3 and 4 also received, on-demand, 2.5 mg i.v. bolus doses of morphine. ⋯ Side-effects were similar and no cases of heavy sedation or respiratory depression were observed. We conclude that a morphine 0.4 mg/kg/day infusion is a safe and effective alternative to on demand dosing in healthy patients after elective cholecystectomy, achieving better analgesia without increasing side-effects. Clonixin 400 mg/day seems to add no significant benefits.