Israel journal of medical sciences
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Randomized Controlled Trial Clinical Trial
Use of the modified technique of ultrafiltration in pediatric open-heart surgery: a prospective study.
The use of cardiopulmonary bypass (CPB) in children is associated with significant morbidity due to the accumulation of an excessive amount of water. This can be decreased by massive diuresis, peritoneal dialysis, or conventional ultrafiltration technique (CUF) during bypass. However, we were dissatisfied with their effect on the outcome of our young patients, and recently began to use the modified technique of ultrafiltration (MUF) with good results. ⋯ No significant difference was found in urine output or the use of diuretics between the two groups. MUF results in better hemodynamic status in children, with the added advantage of less transfused blood and blood products. We believe that the use of accepted surgical techniques in combination with MUF will further improve the outcome of complex cardiac malformations.
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Randomized Controlled Trial Clinical Trial
A prospective study evaluating the usefulness of continuous supplemental oxygen in various endoscopic procedures.
The influence of oxygen supplementation on the prevalence of hypoxemia during endoscopic procedures was studied in 289 patients in a prospective clinical trial. The frequency of oxygen desaturation was found to decrease significantly in patients receiving oxygen via nasal prongs, compared to patients not receiving oxygen supplementation. ⋯ Similar effects were found in patients undergoing gastroscopy, colonoscopy, and endoscopic retrograde cholangiopancreatography. In view of the risks related to hypoxemia and its high prevalence in endoscopic procedures (28-50%) we recommend that a routine oxygen supplementation policy be considered in every patient undergoing endoscopy, especially when additional procedures are to be performed.
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Randomized Controlled Trial Clinical Trial
Asymptomatic or mildly symptomatic effort-induced myocardial ischemia: plasma beta-endorphin and effect of naloxone.
The hypothesis that endogenous opioids may be involved in reduced exercise-induced ischemic pain or in silent ischemia was tested. Fifteen male patients with coronary artery disease were tested in a randomized, double-blind crossover study. After a preliminary screening effort test they were divided into two groups: the first group of nine patients received an i.m. injection of naloxone 0.4 mg, or saline as placebo, and the second group, comprising six patients, received 4 mg naloxone or saline i.v. ⋯ Beta-endorphin concentrations in plasma were significantly increased following exercise in the second group of patients. The increase in beta-endorphin concentration was larger when the patients were pretreated with naloxone (4 mg) than with placebo. However, chest pain was not significantly altered by either dose of naloxone.