European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Jan 1993
Comment Letter Comparative Study Clinical TrialIntercostal nerve block, interpleural analgesia, thoracic epidural block or systemic opioid application for pain relief after thoracotomy?
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Eur J Cardiothorac Surg · Jan 1993
Randomized Controlled Trial Comparative Study Clinical TrialArrhythmia prophylaxis after coronary artery surgery. A randomised controlled trial of intravenous magnesium chloride.
One hundred and thirty patients undergoing elective myocardial revascularisation were randomised to receive an intravenous infusion containing either 50 mmol magnesium chloride or placebo during the first 48 h following surgery. Magnesium was given to 66 patients and a placebo infusion to 64 patients. Postoperative serum magnesium concentrations fell in the placebo group (from 0.83 +/- 0.06 to 0.79 +/- 0.11 mmol/l) but were elevated in the magnesium group (from 0.82 +/- 0.05 to 1.2 +/- 0.25 mmol/l). ⋯ Three patients in the magnesium group had an episode of ventricular fibrillation and three patients in the placebo group had frequent ventricular ectopics. There was one death in the magnesium group associated with a perioperative myocardial infarction. This study shows that intravenous magnesium supplements reduce the incidence of supraventricular arrhythmias following coronary artery surgery.
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Eur J Cardiothorac Surg · Jan 1993
Editorial ReviewOrgan dysfunction and cardiopulmonary bypass: the role of complement and complement regulatory proteins.
Cardiopulmonary bypass-induced organ dysfunction remains a clinical problem in certain groups of patients. Although the pathogenesis is multifactorial, it is likely that a panendothelial injury consequent upon widespread humoral and cellular activation is a major contributor to this process. The biologically active products of complement activation are certainly capable of inducing many of the features of the post-perfusion syndrome. ⋯ Haworth, Personal Communication) whilst pre-existing sepsis could clearly induce a degree of endothelial dysfunction. A further possibility is that the inflammatory response in these patients is already "primed". Some patients with heart failure have been shown to have elevated circulating TNF.(ABSTRACT TRUNCATED AT 400 WORDS)
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Eur J Cardiothorac Surg · Jan 1993
Case ReportsEndobronchial hamartoma resected by rigid bronchoscope.
Endobronchial hamartomas are not very common and they are usually symptomatic because of bronchial obstruction. The diagnosis is made by fiberoptic bronchoscopy of thoracotomy and there are several possibilities of treatment but until now the most common has been surgical resection. We report the case of a man with an endobronchial hamartoma who was diagnosed by fiberoptic bronchoscopy and successfully treated by rigid bronchoscopy.
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Eur J Cardiothorac Surg · Jan 1993
Case ReportsDelayed brachial plexus paralysis due to subclavian pseudoaneurysm after clavicular fracture.
Injuries to the brachial plexus and subclavian artery are serious complications of shoulder girdle trauma. Due to the close anatomical relationship between the brachial plexus and the subclavian artery in the thoracic outlet, both structures are often simultaneously involved in shoulder girdle injuries. Isolated lesions of the subclavian artery or the brachial plexus can also occur, especially with clavicular fractures. When a false subclavian aneurysm leads to a gradually increasing compression of the brachial plexus, the neurological signs and symptoms develop insidiously after the traumatic event.