Langenbecks Archiv für Chirurgie. Supplement II, Verhandlungen der Deutschen Gesellschaft für Chirurgie. Deutsche Gesellschaft für Chirurgie. Kongress
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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.
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Langenbecks Arch Chir Suppl II Verh Dtsch Ges Chir · Jan 1990
[Monitoring and management of the central nervous system in treatment of tumor cachexia].
After palliative surgery artificial nutrition is indicated primarily in patients receiving postoperative chemotherapy or radiotherapy. The techniques of ambulatory enteral or parenteral nutrition have been standardized during the past decade. ⋯ An improvement of the nutritional status can be expected in most of the patients. Further clinical trials are needed to determine whether the patients' quality of life improves.