Intensive care medicine
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The necessity of surgical procedures for insertion as well as for removal of the balloon catheter remains a serious disadvantage of IABP. The percutaneous technique of insertion and removal of a specially designed balloon catheter is therefore of a great interest. ⋯ No specific complications were encountered although two cases of pulmonary embolism were recorded. A causal relationship between pulmonary embolism and the percutaneous removal of a balloon catheter must therefore be considered.
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A retrospective review was undertaken of 169 patients admitted to an Intensive Therapy Unit with a major chest injury to determine the incidence, clinical features and outcome of patients with myocardial contusion. This injury occurred in 29 (17%) patients, of whom 24 (83%) had significant cardiovascular complications and five died as a direct result of the injury. The interval between injury and diagnosis was 3.2 +/- 2.3 days (mean +/- SD) from injury and in six patients the diagnosis was made only at necropsy. Increased awareness of myocardial contusion is required for earlier diagnosis and prevention of complications.
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Insensible fluid losses were estimated using fluid balances and body weight changes in twelve artificially ventilated patients with severe tetanus. Studies were carried out over initial twenty day periods of treatment on six patients aged between 26 and 49 years and six aged 63 to 78. ⋯ When quantified, insensible fluid losses appeared greatest in the younger patients (up to 3.81 per day) and increased throughout the period of study. Dehydration will tend to occur unless the magnitude of these insensible losses is appreciated and taken into account when managing fluids.