Articles: postoperative-complications.
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J. Neurol. Neurosurg. Psychiatr. · Nov 1980
The treatment of raised intracranial pressure following aneurysm surgery.
The effect of intravenous mannitol infusion and withdrawal of cerebrospinal fluid on the intracranial pressure and clinical state was studied in 26 patients with raised intracranial pressure after direct surgery for ruptured aneurysm. Each method decreased the mean intracranial pressure by about 60% of the pre-treatment level. The maximal decrease following mannitol occurred after 60-90 minutes and generally lasted between three and four hours. ⋯ Withdrawal of cerebrospinal fluid lowered the intracranial pressure immediately and the effect persisted for approximately 60 minutes. This could be repeated as often as necessary and was without systemic disturbance, although a patent intraventricular catheter was necessary. The two methods could be used simultaneously.
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Clin. Orthop. Relat. Res. · Oct 1980
Post-fracture avascular necrosis of the femoral head: correlation of experimental and clinical studies.
Both extraosseous and intraosseous blood supply of the femoral head are susceptible to injury in patients with femoral neck fractures. The injury to the extraosseous vessels is proportional to the amount of displacement at the time of fracture. The major intraosseous vessels are damaged if the fracture extends through the superior lateral portion of the neck or head. ⋯ The arthritic changes seen in some patients three or more years after femoral neck fracture seem to be initiated by collapse and fragmentation of small areas of avascular necrosis in or near the weight-bearing portion of the head. The various methods currently available for predicting the vascularity of the head at the time of fracture are not sufficiently quantitative to be used on a routine clinical basis. Biologic factors may explain the difference in the incidence of avascular necrosis in the adult femoral head epiphysis compared with that in the metaphysis and explain why the area of revascularization and reossification of avascular bone is so limited.
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Randomized Controlled Trial Comparative Study Clinical Trial
Efficiency of two variable performance techniques of oxygen therapy in relieving postoperative hypoxaemia.
The efficiency of two patient-dependent, variable performance techniques of oxygen therapy in relieving hypoxaemia after upper abdominal surgery was compared. A high-flow system delivered a humidified mixture of oxygen 2 litre min-1 and air 13 litre min-1 through a cannula inserted into the anterior nares. ⋯ With the patients breathing room air, arterial hypoxaemia could be demonstrated with Pao2 inversely related to age. The increase of Pao2 during either oxygen treatment was significantly greater with the low flow system.