Articles: surgery.
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The dramatic decline in mortality related to cardiac surgery has resulted in over 330,000 surgeries involving cardiopulmonary bypass (CPB) being performed yearly in the United States. Although few patients die as a result of cardiac surgery, over two thirds of the patients demonstrate evidence of acute neuropsychological dysfunction postoperatively. The potential mechanisms contributing to post-CPB neuropsychological deficits are many, but two major inter-related etiologic factors, hypo-perfusion and emboli, are suggested as the probable culprits. ⋯ Conversely, if hypoperfusion is the cause of the injury, then decreasing brain blood flow to minimize embolic delivery would increase the likelihood of perfusion injury. By monitoring the carotid arteries of patients undergoing coronary artery bypass graft surgery, we have determined the frequency and quantity of embolic signals that occur during CPB. Although we have not been able to determine the nature of the embolus, gaseous or solid, we have demonstrated a relationship between the overall embolic load and the probability of having NP dysfunction. (ECHOCARDIOGRAPHY, Volume 13, September 1996)
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Otolaryngol Head Neck Surg · Jul 1996
Biography Historical ArticleFacial plastic surgery: subspecialty helps otolaryngology define its boundaries.
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Zhonghua Zheng Xing Shao Shang Wai Ke Za Zhi · May 1996
[Early postoperative hypoxemia in infants, children and adults undergoing elective plastic surgery].
Seven hundred ASA-class-1 patients undergoing elective plastic surgery were selected to study the effect of age on early postoperative hypoxemia with a pulse eximeter for continuous monitoring of arterial oxygen saturation (SpO2) in the postanesthesia recovery room. The patients were divided into four groups: group 1, 72 infants aged less than one year; group 2, 120 children aged from one to three years; group 3, 364 children aged over three years; and group 4, 144 adults aged from 18 to 58 years. ⋯ The incidences of early postoperative hypoxemia in the postanesthesia recovery room were 44.4% in group 1, 31.7% in group 2, 17.3% in group 3 and 8.3% in group 4. Early postoperative hypoxemia occurred most commonly within 40 min. in infants and within 15 min. in children aged over one year and adults.
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Eur J Orthop Surg Tr · May 1996
Post operative infections of the spine: technique, indications and results of the surgical treatment - A retrospective study of 90 cases.
Post operative infection in spine surgery is a well known complication. The authors studied a series of 90 patients in accordance with an homogenous strategy based on the excision of necrotic and infected tissues, associated with appropriate antibiotics. The results are analyzed according to the degree of infection (which is based on the type of germs and their associations), and type of patients, the delay in diagnosis and the anatomical extension of the infected lesions. ⋯ Dans cette série, les auteurs ne signalent aucune complication neurologique dûe à l'infection. Néanmoins, 8 décès sont à déplorer chez des patients fragiles avec signes neurologiques initiaux. Ceci souligne l'importance du traitement général associé à la chirurgie et la nécessité d'un bilan complet de ces malades.