Articles: postoperative-complications.
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Previous studies of psychiatric complications following open heart surgery have included few if any patients who had coronary bypass surgery. This experiment reports the relative incidence of psychiatric complications in a sample of 97 open heart surgery patients of whom 51 patients (53 per cent) had coronary bypass surgery. The results suggest that the incidence of psychiatric symptoms following coronary bypass surgery is significantly lower (16 per cent) than that following cardiac valvular surgery (41 per cent). Several possible reasons for this large discrepancy in incidence of psychiatric complications are considered.
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Dopamine and isoproterenol were each administered in two different doses to 12 patients with coronary artery disease in the period immediately after open heart surgery. The two doses of dopamine resulted in respective increases in cardiac output of 23 and 43 percent and reductions in systemic vascular resistance of 23 and 32 percent; neither dose significantly altered heart rate. The two doses of isoproterenol caused respective increases of 23 and 37 percent in cardiac output and 18 and 28 percent in heart rate and reductions in systemic vascular resistance of 22 and 29 percent. We conclude that lack of chronotropic effect of dopamine as compared with isoproterenol may make the former the agent of choice in patients requiring inotropic agents for their care in the early period after cardiac surgery.
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Arterial blood and expired gas samples were taken from 20 patients before operation and on the first day after upper abdominal surgery. After operation the patients were studied breathing air and also breathing 35% oxygen from a venturi-type mask. ⋯ The postoperative Pao2 during oxygen therapy correlated well with the postoperative Pao2 breathing air. Severely hypoxaemic patients show less improvement of oxygen tension during 35% oxygen therapy.