Surgery, gynecology & obstetrics
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Surg Gynecol Obstet · Oct 1976
Continuous positive airway pressure in the prophylaxis of the adult respiratory distress syndrome.
After an operation upon the abdomen, certain patients have a high risk of developing acute respiratory failure or the adult respiratory distress syndrome. These patients at high risk have been mechanically ventilated during the postoperative period in an attempt to prevent the onset of respiratory insufficiency. As a method of prophylaxis, continuous positive airway pressure has the advantages of increasing the functional residual capacity with minimal effects on the cardiac output, low potential for barotrauma and simplicity of equipment. ⋯ In ten controls, adult respiratory distress syndrome developed, and three died in respiratory failure. Only one of the group receiving continuous positive airway pressure met standard criteria for the diagnosis of adult respiratory distress syndrome. In addition, in 25 patients serving as controls, respiratory complications other than adult respiratory distress syndrome developed compared with the development in only 11 receiving continuous positive airway pressure9
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The records of 98 patients with trauma of the bladder were reviewed. Eighty per cent were injured as a result of blunt trauma, and 72 per cent of these patients had an associated fracture of the pelvis. ⋯ While all patients with intraperitoneal ruptures of the bladder were treated by surgical repair, half of those with extraperitoneal ruptures were successfully managed by catheter drainage alone. Complications of therapy consisted of bacterial cystitis, presumably as a result of catheter drainage.