Annales chirurgiae et gynaecologiae. Supplementum
-
Ann Chir Gynaecol Suppl · Jan 1982
Fat embolism syndrome--a variant of post-traumatic pulmonary insufficiency.
The fat embolism syndrome is defined as a variant of post-traumatic pulmonary insufficiency complicating musculoskeletal trauma. It occurs up to 28% of cases depending to a certain extent on the magnitude of the trauma. Tissue fat embolization into pulmonary and other capillaries and microthrombus formation appear to be the factors causing the microvascular disorder in the lungs, brain, kidneys, skin etc. ⋯ Early and effective stabilization of fractures and pharmacological glucocorticoid therapy appear to be beneficial. The syndrome is usually self-resolving after several days. The central clinical problem is early detection of the syndrome.
-
Ann Chir Gynaecol Suppl · Jan 1982
Intermittent mandatory ventilation (IMV): a primary ventilatory support mode.
Respiratory therapy should be directed at underlying pathophysiology, not symptomatology. Mechanical ventilation, oxygen, and CPAP should be administered to patients independently and in appropriate amounts. Removal of each of these therapeutic interventions should occur in a similar fashion. ⋯ This approach minimizes the detrimental effects of mechanical ventilatory support on acid-base balance and cardiovascular function and decreases the possibility of pulmonary barotrauma. Twelve years of prospective evaluation have demonstrated numerous advantages of IMV. This approach has simplified the management of patients with compromised respiratory function and has decreased morbidity and mortality (10).