Articles: postoperative-complications.
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Acta Anaesthesiol Scand · Aug 1979
Can postoperative pulmonary conditions be improved by treatment with the Bartlett-Edwards incentive spirometer after upper abdominal surgery?
During the immediate postoperative course after upper abdominal surgery, pulmonary complications often occur, caused, inter alia, by reduced regional ventilation and by atelectases as a result of: (1) narrowing of the small peripheral bronchi, and (2) impaired respiratory function. Based on these pathophysiological mechanisms, an instrument (Bartlett-Edwards Incentive Spirometer) has been devised, which aims at giving the patient an opportunity of sustained maximal inspiration under standardized and controlled conditions. ⋯ In general, we have a low frequency of severe postoperative pulmonary complications, as compared with the results reported in the literature. We ascribe this to our very effective pre- and postoperative respiratory therapy.
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J. Thorac. Cardiovasc. Surg. · Jul 1979
Heparin administration during extracorporeal circulation: heparin rebound and postoperative bleeding.
The individual variations in heparin dose response and heparin activity decay have indicated limitations of the protocols based on body surface area and weight of the patients. In the present study the heparin levels and simpler clotting tests were monitored in a consecutive series of 71 patients undergoing standard cardiac operations. The clotting tests used were the Celite activated clotting time (Celite ACT) and the whole blood activated recalcification time (BART). ⋯ A significant difference was seen in the measured heparin levels (p less than 0.01, Celite ACT (p less than 0.01), and BART (p less than 0.01) in patients on Protocols I and II. Ten of the 24 patients on Protocol I and none on Protocol II showed heparin rebound phenomenon, and blood loss in patients on Protocol I was significantly greater than that in patients on Protocol II. The study clearly demonstrates that our protocol of heparin administration and control with simpler tests ensures safe hypocoagulation during ECC and efficient reversal at the end, with minimal postoperative blood loss.