Langenbecks Archiv für Chirurgie. Supplement II, Verhandlungen der Deutschen Gesellschaft für Chirurgie. Deutsche Gesellschaft für Chirurgie. Kongress
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Organ injuries are a frequent occurrence: The Surgical Department of Wuerzburg University treated 270 patients between 1983 and 1987. More than one-fifth of these patients had undergone primary surgery at other hospitals and came to us for reoperation or intensive care. The successful treatment of such severe and often multiple, simultaneous injuries depends on well-trained surgeons whose undelayed consultation with specialists is not impeded by bureaucratic hospital organization.
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Langenbecks Arch Chir Suppl II Verh Dtsch Ges Chir · Jan 1990
Review[Perioperative respiratory therapy and postoperative pain therapy].
Especially patients with preexisting bronchopulmonary diseases or those undergoing operations in the upper abdomen or thoracotomies are susceptible to post-operative pulmonary complications. All patients at risk should learn the prophylactic respiratory maneuvers preoperatively. ⋯ If given in an equipotent dose, nearly every opioid provides sufficient postoperative analgesia. Wide interindividual variation in the needed dose requires that opioids be titrated intravenously.
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Langenbecks Arch Chir Suppl II Verh Dtsch Ges Chir · Jan 1990
Review[Acute respiratory distress syndrome of the adult: are there new therapeutic approaches?].
The mortality of adult respiratory distress syndrome (ARDS) remains high despite increasing understanding of the syndrome's pathophysiology, better monitoring and new ventilatory techniques. The outcome can be improved adequate systemic oxygen availability, improved infection control, and biochemical monitoring and interventions. Only by combinating of several treatment modalities is there a reasonable chance to change the prognosis of ARDS.
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Langenbecks Arch Chir Suppl II Verh Dtsch Ges Chir · Jan 1990
[Postoperative lung complications--introduction].
Intensive care patients suffer according to literature in 20-60% from pneumonia with a mortality up to 80%. The patient, operation and postoperative therapy influence its pathogenesis. ⋯ Specifity of clinical and plain X-ray diagnosis is only 30-50%. Selective gastrointestinal decontamination, exactly monitored fluid balance, and physio-, and paintherapy seem to be valuable preventive measures.
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Langenbecks Arch Chir Suppl II Verh Dtsch Ges Chir · Jan 1990
Review[Diagnosis and monitoring of postoperative pulmonary complications].
There is no distinct difference between regular postoperative pulmonary changes and postoperative pulmonary complications (PPC). Beside the "classic" PPC, atelectases and bronchopneumonia, adult respiratory distress syndrome (ARDS) and barotraumas are becoming of increasing importance. ⋯ The varieties of germs found in bronchial secretions and lung parenchyma, however, are not considerably different. CAT scan seems to be the best diagnostic imaging tool for the follow-up of ARDS and barotrauma.