Recenti progressi in medicina
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The author describes the frequencies and characteristics of psychopathological disorders before and after open heart surgery. In addition to cognitive and anxious-depressive mood disorders in the preoperative time, anxiety and coping are prominent. ⋯ Conditions and causes of psychopathological disorders are discussed with the aid of the literature and present results. Therapeutic possibilities are outlined.
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The presence of dynamic hyperinflation and intrinsic PEEP is a common and yet too often unrecognized occurrence in patients with airway obstruction both in stable state and during acute exacerbations. Intrinsic PEEP may represent an important load on the inspiratory muscles which are operating at a mechanical disadvantage due to hyperinflation. ⋯ The presence of intrinsic PEEP also has other important clinical ramifications. Prompt recognition of intrinsic PEEP will allow for proper measurement and interpretation of a variety of cardiopulmonary parameters and improved clinical decision making and management of these critically ill patients.