RESUMO
Cutaneous blood flow may be measured utilizing a continuous, noninvasive technique, laser Doppler velocimetry (LDV). Monitoring of cutaneous blood flow by LDV might be a useful method to monitor cardiac output. To test this hypothesis, sequential measurements of cardiac output, LDV, and transcutaneous oxygen (PtcO2) were made on 10 anesthetized dogs during experimental shock. There was significant correlation between LDV and cardiac output, while PtcO2 reflected cardiac output only at low flow states. These results show that, in the animal model, cutaneous LDV is a sensitive and specific method for monitoring cardiac output changes.
Assuntos
Débito Cardíaco , Pele/irrigação sanguínea , Animais , Cães , Lasers , Monitorização Fisiológica/instrumentação , Oxigênio/sangue , Respiração com Pressão Positiva , Fluxo Sanguíneo Regional , Choque Hemorrágico/fisiopatologiaRESUMO
Fluosol-DA 20% (Fluosol), a perfluorochemical emulsion capable of improving oxygen transport, was used to treat three patients with life-threatening hemorrhage. In each case a decreased partial pressure of oxygen, an increased alveolar-arterial oxygen gradient, fever, an increased white blood cell count, and chest x-ray abnormalities occurred at similar time intervals after treatment with Fluosol. In one patient, pulmonary complications were fatal. Similar adverse reactions to treatment with Fluosol have not been previously reported. Possible explanations for these pulmonary complications are the adult respiratory distress syndrome, oxygen toxicity, or direct toxic effects of Fluosol.
Assuntos
Substitutos Sanguíneos/efeitos adversos , Fluorocarbonos/efeitos adversos , Hemorragia/terapia , Pulmão/efeitos dos fármacos , Adulto , Idoso , Cristianismo , Combinação de Medicamentos/efeitos adversos , Feminino , Hemorragia/complicações , Humanos , Derivados de Hidroxietil Amido , Pulmão/fisiopatologia , Masculino , Oxigênio/fisiologia , Síndrome do Desconforto Respiratório/induzido quimicamenteRESUMO
Whether bile reflux through a common channel into the pancreatic duct is a causative factor in the development of gallstone pancreatitis is controversial. To address this issue, we have reviewed a consecutive series of cholecystectomies performed with intraoperative cholangiograms. The cholangiograms and the patients' charts were reviewed independently to determine the incidence of a common channel in patients both with and without pancreatitis and to analyze their clinical courses. The group of patients who had pancreatitis showed a common channel in 19 (90%) of 20 cases, while those patients who did not have pancreatitis showed a common channel in 23 (35%) of 66 cases. The patients who had pancreatitis were less likely to have choledocholithiasis than were those patients who did not have pancreatitis, and these patients were less likely to require exploration of the common bile duct.