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
Comparative Study[Blunt abdominal trauma: practical diagnostic strategy].
The principal aim of a practical diagnostic strategy is rapidly identify the organ injury following blunt abdominal trauma. A general diagnostic strategy and special technical investigations are described and their relative values discussed. ⋯ Its sensitivity was 96% and specificity 98%. Following examination by ultrasound the rate of negative laparotomies was 1.3%.
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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
[Simplified surgical procedure for closure of the ductus arteriosus in premature infants].
The necessity of closing a hemodynamically significant patent ductus arteriosus (PDA) in a premature neonate is unequivocal. Until 12/86 the PDA was disected and ligated and a chest tube was inserted (127 pts.) Since 1/87 45 pts. (weight less than 1500 g) underwent PDA-closure using a metal-clip and no chest tube. Simplified surgical technique in closure of PDA in the premature neonate has led to a marked reduction of operating time (mean from 36 to 18 min) and has decreased the incidence of perioperative complications.
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Langenbecks Arch Chir Suppl II Verh Dtsch Ges Chir · Jan 1990
[Fluid balance and postoperative lung function].
Postoperative volume therapy: 1. Replacement of fluid loss. 2. Therapy of intravasal hypovolaemia in case of permeability damage or intracellular fluid shift. ⋯ Differential treatment has to be based on additional measurement of cardiac output and pulmonary capillary pressure. Volume treatment in postoperative complications is essential because of intravasal hypovolaemia. Kidney and cardiac failure have to be ruled out.
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Langenbecks Arch Chir Suppl II Verh Dtsch Ges Chir · Jan 1990
[Extracorporeal membrane oxygenation and CO2 elimination].
The mortality in patients with ARDS stage IV is 90% according to the classification of Morel (1985) since all experiments as treatment with prostaglandine antagonists and application of antioxidants have to improve the outcome of such patients, we treated 87 patients, aged 5-51 years, between 1985-1990, with a veno-venous extra-corporeal bypass for CO2-elimination and with low frequency positive pressure ventilation according to the method of Kolobow et al. Forty-six of 87 patients survived, i.e. the mortality was reduced to 47%. This is striking evidence that this method is superior to other treatments of patients with ARDS.