Articles: critical-care.
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Anaesthesiol Reanim · Jan 1994
Case Reports[Life threatening tension pneumothorax after puncture of the subclavian vein and dislocation of thoracic drainage].
The combination of two rare complications in intensive care caused an acute life-threatening situation. Following puncture of the left subclavian vein a pneumothorax developed over the course of a couple of days. The inserted thoracic drain dislocated into the subcutaneous tissue. ⋯ Finally, the tension pneumothorax was diagnosed by x-ray of the chest. This life-threatening situation could be treated by the insertion of a thoracic drain. The operation could be performed without any problems.
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Report about the treatment of necrotizing pancreatitis in the years 1988 until 1991. A rigorous conservative therapy was preferred, so that only 8.6% of the 140 patients underwent surgery. In 11 cases a continuous venous-venous hemofiltration (CVVH) was applied to patients with most serious clinical course and multi-system failure. ⋯ The present results show, that, eliminating mediators by hemofiltration, system failure in connection with sterile necrosis can be treated with a good success rate. Therefore toxic organ failure should no longer be regarded as an imperative indication for operation. We recommend strict intensive care including CVVH and antibiotical prophylaxis for treatment of sterile necrosis, while surgical therapy should only be applied to patients with bacterial contamination of pancreatic necrosis.
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Ann Fr Anesth Reanim · Jan 1994
[Training in anesthesiology and surgical intensive care in the United Kingdom].
A review of the training in anaesthetics in the United Kingdom is presented. After basic medical training and obtaining the MB BS qualification, the trainee will usually spend a year outside anaesthetics. Following this period, basic specialist training takes approximately four years, going through senior house officer and registrar grades, leading to the Fellow of the Royal College of Anaesthetist (FRCA) diploma. ⋯ A Certificate of Accreditation is awarded after three years of satisfactory experience in a senior registrar post. The accredited senior registrar is then ready to apply for a consultant vacancy or a senior lecturer's post. Academic appointments are made at registrar and senior registrar levels (lecturers) and consultant level (as senior lecturers and professors).