ABSTRACT
The authors report an investigation of 331 consecutive patients submitted to major surgery to evaluate the reliability of temperature monitoring in different body sites in relation to central temperature. After having considered the minimal temperature changes and the difficulties due to the different techniques used, it is concluded that the measurement at the middle 3rd of the oesophagus is the most reasonable measurements site.
Subject(s)
Body Temperature , Monitoring, Intraoperative/methods , HumansABSTRACT
The authors report the use of a total intravenous anaesthesia in CABG. An association of propofol-fentanyl-pancuronium with a bolus at induction, then with continuous perfusion was used. Hemodynamic and oxymetric data obtained from the right heart and radial artery samples show good hemodynamic stability during surgery. It is underlined that, in order to reduce possible hemodynamic changes it is very important to use, during the surgical procedure, the lowest drug concentration.
Subject(s)
Coronary Artery Bypass , Fentanyl/administration & dosage , Pancuronium/administration & dosage , Propofol/administration & dosage , Aged , Fentanyl/pharmacology , Hemodynamics/drug effects , Humans , Male , Middle Aged , Pancuronium/pharmacology , Propofol/pharmacologyABSTRACT
The authors report on a group of 8 patients in septic shock, treated with NA in association with dopamine and/or dobutamine, according to a personal therapeutic protocol. The use of NA in septic shock with low SVR showed an improvement in hemodynamic condition and a higher survival rate in the treated patients. During the study many clinical, laboratory and microbiologic data were also recorded.
Subject(s)
Hemodynamics/drug effects , Norepinephrine/pharmacology , Shock, Septic/drug therapy , Female , Humans , Male , Middle Aged , Norepinephrine/therapeutic use , Shock, Septic/physiopathologyABSTRACT
A drastic reduction in homologous blood or plasma transfusion becomes necessary to prevent the risks of severe infections disease transmission. The authors studied the possibility of homologous blood save in cardiac surgery by peroperative autotransfusion. This procedure, although it diminished the average blood bank requirements, above all for an unexplained decrease in postoperative bleeding, did not obtain the good results that other authors had with the technique of 2 or 3 preoperative withdrawal, storage and postoperative reinfusion. In future our trend is to associate preoperative and intraoperative withdrawals to take advantage of both techniques.
Subject(s)
Blood Transfusion, Autologous/methods , Cardiac Surgical Procedures/methods , Intraoperative Care/methods , Blood Loss, Surgical/prevention & control , Humans , Postoperative PeriodABSTRACT
A patent ductus arteriosus in adults is a rare eventuality. After correct diagnosis, an accurate evaluation of pulmonary vascular resistances is necessary with, in case of normality, a straightforward indication to surgery, because the evolution of the disease cannot be predicted. In case of pulmonary hypertension irreversible pulmonary vascular damage must be excluded. Haemodynamic data such as pressures, flows and resistance ratios are not reliable. According to the majority of Authors the value of pulmonary resistances seems to be more accurate, and when more then 8 u/m2 an histological specimen must be obtained. In our experience a comparative study between the Health and Edwards method and the Yamaki et al., one shows, confirmed by postoperative follow-up, a greater reliability of the second one.
Subject(s)
Ductus Arteriosus, Patent/diagnosis , Hypertension, Pulmonary/diagnosis , Adult , Aged , Ductus Arteriosus, Patent/mortality , Ductus Arteriosus, Patent/physiopathology , Ductus Arteriosus, Patent/surgery , Female , Follow-Up Studies , Hemodynamics , Humans , Hypertension, Pulmonary/mortality , Hypertension, Pulmonary/physiopathology , Hypertension, Pulmonary/surgery , Male , Middle AgedABSTRACT
The glucose-6-phosphate dehydrogenase (G6PD) enzyme activity was determined in 299 Northern Sardinian patients with cholelithiasis. Sixteen (12.80%) of the 125 male patients studied were G6PD deficient; 33 (18.96%) of the 174 females were heterozygous and 1 (0.57%) homozygous. Thus, the prevalence of G6PD deficiency in male subjects with cholelithiasis is about 35% higher (p less than 0.02) than that of a normal male control group (7.29%). As regards female patients, the incidence of the GdMed allele was also significantly different (p less than 0.05). Thus, G6PD-deficient subjects may have a predisposition to develop gallstones, even in the absence of clinical signs of chronic hemolysis.
