Canadian journal of surgery. Journal canadien de chirurgie
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Randomized Controlled Trial Comparative Study Clinical Trial
Heparinized saline versus normal saline in maintaining patency of the radial artery catheter.
To compare the ability of normal versus heparinized saline infusion to maintain patency of the radial artery catheter used for monitoring or multiple blood sampling. ⋯ There is no significant difference between flushing with normal saline and heparinized saline in the maintenance of radial arterial line patency. However, the use of a continuous heparinized flush solution in pressurized arterial lines is beneficial in that it results in greater accuracy of blood pressure monitoring than normal saline infusion.
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Randomized Controlled Trial Clinical Trial
Use of desmopressin acetate to reduce blood transfusion requirements during cardiac surgery in patients with acetylsalicylic-acid-induced platelet dysfunction.
To determine whether desmopressin acetate (DDAVP) has the ability to reduce blood loss in patients with a known bleeding tendency. ⋯ DDAVP reduces blood loss during cardiac bypass surgery in patients who have taken acetylsalicylic acid within 7 days before operation.
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Randomized Controlled Trial Clinical Trial
Cardiac compliance and effects of hypertonic saline.
To demonstrate the advantages of a 1.8% hypertonic saline solution (HS) over a Ringer's lactate solution (RL) during and after major intra-abdominal surgery, 28 patients were randomly allocated to one of two groups as follows: 13 patients received RL and 15 patients received HS. All patients were studied preoperatively, peroperatively and postoperatively for 72 hours. Peroperatively RL or HS were infused at a rate sufficient to maintain a pulmonary capillary wedge pressure (PCWP) and central venous pressure (CVP) within 3 mm Hg of the initial value. ⋯ The HS group received significantly (p = 0.002) less liquid than the RL group. At the end of surgery, the LVEDVI dropped in both groups. This drop was significantly (p = 0.04) more important in the RL group than in the HS group.(ABSTRACT TRUNCATED AT 250 WORDS)
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Randomized Controlled Trial Clinical Trial
The conduct of cholecystectomy: incision, drainage, bacteriology and postoperative complications.
The benefits of some ancillary techniques of cholecystectomy are exaggerated by retrospective study of selected patients. Therefore, the authors performed a prospective, randomized study of 100 consecutive patients who underwent simple elective cholecystectomy for chronic cholecystitis and cholelithiasis. No patient was excluded because of incomplete hemostasis or fear of bile leakage. ⋯ Peritoneal drainage was found to be unnecessary. Short-term drainage may increase the frequency of postoperative fever, but did not increase pulmonary complications or wound infections. In these patients, intra-abdominal sepsis is rare; wound infections were uncommon and the gallbladder bile was usually sterile and not the cause of postoperative infection.
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Randomized Controlled Trial Clinical Trial
Does pericardial drainage decrease the frequency of postpericardiotomy syndrome?
The postpericardiotomy syndrome occurs in 10% to 40% of patients who undergo open-heart surgery. Its frequency is reportedly decreased when pericardial drainage is used. To challenge this, 50 consecutive patients (1 was disqualified) were randomly assigned to two groups: one in which only the anterior mediastinum was drained (group 1) and the other in which the anterior mediastinum and posterior pericardium were drained (group 2). ⋯ However, none had postpericardiotomy syndrome complicating coronary artery bypass surgery. None of the patients had cardiac tamponade. This study demonstrates that pericardial drainage has no effect on the frequency of postpericardiotomy syndrome and appears to be unnecessary after open-heart surgery.