Articles: postoperative-complications.
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To examine the relationship between sleep loss and confusion after open-heart surgery, 27 consecutive patients were monitored 1 day preoperatively and 5 days postoperatively with the Folstein Mini-Mental State examination, a modified sleep latency test, and a sleep log. Confusion (low Mini-Mental State scores) peaked on postoperative Days 1 and 2 and correlated with insomnia (sleep time) during the following night but not during the preceding night. The results suggest that sleep loss is not the cause but, rather, a consequence of postcardiotomy confusion. Confusion, not insomnia, should be the focus of treatment.
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British heart journal · Nov 1987
Continuous arteriovenous haemofiltration in children with postoperative cardiac failure.
Six children with refractory heart failure were treated by continuous arteriovenous haemofiltration. The cause of the failure was postoperative fluid overload or low cardiac output with anuria or oliguria. This produced a mean (2 SD) negative fluid balance of 1.4 (0.6) ml/kg/h and reduced mean (2 SD) body weight from 4.7 (2.2) to 4.2 (2.3) kg over a period of 57.5 (31.1) hours. ⋯ All but one was weaned from artificial ventilation and catecholamine treatment. No adverse haemodynamic effects were noted. One child need operation for a femoral artery thrombosis after 12 days of continuous arteriovenous haemofiltration.
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J. Thorac. Cardiovasc. Surg. · Oct 1987
Randomized Controlled Trial Comparative Study Clinical TrialAtrial activity during cardioplegia and postoperative arrhythmias.
Cardioplegia provides excellent protection for the left ventricle, but the right atrium may be poorly protected. Myocardial temperatures, right atrial electrical activity, and postoperative arrhythmias were assessed in 103 patients participating in two consecutive randomized trials comparing blood cardioplegia (n = 36), crystalloid cardioplegia (n = 38), and diltiazem crystalloid cardioplegia (n = 29). Both right atrial and right ventricular temperatures were significantly warmer (p less than 0.05) during delivery of the blood cardioplegic solution than during delivery of either the crystalloid or the diltiazem crystalloid cardioplegic solutions; the aortic root temperatures were 9 degrees +/- 2 degrees C with blood cardioplegia and 5 degrees + 1 degrees C with both crystalloid and diltiazem crystalloid cardioplegia. ⋯ Blood cardioplegia reduced supraventricular arrhythmias by reducing ischemic injury despite warmer intraoperative temperatures and more right atrial activity. Diltiazem crystalloid cardioplegia reduced postoperative arrhythmias by improving intraoperative myocardial protection and suppressing intraoperative and postoperative atrial activity. Crystalloid cardioplegia cooled but did not arrest the right atrium intraoperatively, resulted in the most perioperative ischemic injury, and yielded the highest incidence of postoperative supraventricular arrhythmias.
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Review Case Reports
Chylous ascites after abdominal aortic aneurysmectomy: successful management with a peritoneovenous shunt.
Postoperative chylous ascites is a rare complication of aortic aneurysmectomy. Although increasing numbers of abdominal aortic aneurysms are being resected annually, there have been only eight previously reported cases of chylous ascites after this operation. This article describes the ninth case of postoperative chylous ascites after abdominal aortic aneurysm resection and emphasizes the value of management with peritoneovenous shunting.