Intensive care medicine
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Intensive care medicine · Jan 1988
Case ReportsInadvertent intrathecal administration of amidetrizoate.
Two cases are presented in which amidetrizoate (Urografin) was accidentally introduced into the intrathecal cavity. Intrathecal lavage and continuous administration of thiopentone were very successful in preventing further systemic deterioration.
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Intensive care medicine · Jan 1988
Case ReportsParacetamol-associated coma, metabolic acidosis, renal and hepatic failure.
A case of metabolic acidosis, acute renal failure and hepatic failure following paracetamol ingestion is presented. The diagnostic difficulty at presentation is highlighted. Continuous arteriovenous haemofiltration proved a valuable means of maintaining fluid and electrolyte balance. The patient recovered.
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Intensive care medicine · Jan 1988
Central mixed and splanchnic venous oxygen saturation monitoring.
Central mixed venous oxygen saturation (SvO2) monitoring in critically ill patients to estimate adequacy of peripheral perfusion is gaining increasing popularity. However, a number of unexpected responses, one of which is marked depression of regional (splanchnic) venous oxygen saturation which may coexist with normal or high SvO2, makes interpretation of this parameter difficult. The SvO2 and hepatic venous oxygen saturation levels in seven injured (postoperative) and 15 septic patients were measured. ⋯ This reduced oxygen saturation was noted to arise from an increased regional metabolic rate rather than reduced perfusion. Nevertheless, we conclude that a flow limited regional oxygen consumption may potentially exist despite the presence of a normal SvO2 in certain patient subgroups such as septic subjects. Therefore, a normal SvO2 should not be considered as sole criteria to insure optimal oxygen delivery in critically ill patients.
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Intensive care medicine · Jan 1988
Case ReportsPostpartum headache, seizures and bloodstained C.S.F.: a possible complication of dural puncture?
A 32-year-old parturient developed severe headache with subsequent convulsions on the third day after the delivery under epidural anesthesia. Neuroradiological investigations were negative. All complaints disappeared promptly after the performance of an epidural blood patch.