RESUMO
Of 163 patients with intertrochanteric hip fractures 87 received 2 g dicloxacillin and 240 mg of gentamicin preoperatively, and 76 patients had no antibiotic prophylaxis. Preoperative antibiotic prophylaxis was not shown to have any significant effect on wound infections. However, 16 reversible and 1 irreversible cases of kidney toxicity were found among patients receiving antibiotic prophylaxis, whereas there were only four cases of reversible kidney damage among the patients not receiving antibiotics.
Assuntos
Antibacterianos/efeitos adversos , Antibioticoprofilaxia , Dicloxacilina/efeitos adversos , Gentamicinas/efeitos adversos , Fraturas do Quadril/cirurgia , Nefropatias/induzido quimicamente , Penicilinas/efeitos adversos , Adulto , Idoso , Idoso de 80 Anos ou mais , Creatinina/sangue , Feminino , Humanos , Nefropatias/sangue , Masculino , Pessoa de Meia-Idade , Cuidados Pré-Operatórios , Análise de Regressão , Estudos Retrospectivos , Estatísticas não ParamétricasRESUMO
The purpose of the study was to compare use of time with pulse oximetry versus arterial blood gas measurement on the general surgical ward. Eighty patients who had just had major orthopaedic or abdominal surgery were included in the study at two hospitals in Copenhagen. Success rate for pulse oximetry was 100% but only 89% for arterial blood gas measurement, because the laboratory did not analyse samples where the ice surrounding the syringe had melted when arriving at the laboratory or if there were air bubbles in the blood sample. At Hvidovre Hospital the results from the blood gas analysis were delayed median 58 minutes compared with 32 minutes at Sundby Hospital (p < 0.001). The delay at Hvidovre Hospital was largely due to prolonged time for transportation of the sample from the surgical ward to the laboratory by the hospital porter. No patient had hypercapnia or acid-base disturbances requiring treatment. With pulse oximetry reliable monitoring of arterial oxygenation can be obtained non-invasively and with a high success rate. Furthermore, the results are available for the clinician immediately compared with arterial blood gas measurement, where there is a delay in getting the results. We recommend that all general surgical wards should have a portable pulse oximeter for monitoring arterial oxygenation after major surgery.
