Articles: postoperative-complications.
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The purpose of our investigations was to evaluate the influence of disturbed inspiratory gas distribution on postoperative hypoxemia in patients with abnormal lung function undergoing upper abdominal surgery. The lung function analyzer Hewlett-Packard 47402 A was used (Volume-time and flow-volume curves of forced expiration, single and multiple breath nitrogen washout tests with indices of ventilatory gas distribution). It was demonstrated that postoperative hypoxaemia in the undamaged lung is almost exclusively the result of augmented true right to left shunt. ⋯ In patients with borderline lung function this reduction of FRC postoperatively may limit surgical treatment. The management of pain is of great importance in these patients. Continuous epidural anaesthesia certainly produces the best results in this respect.
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Comparative Study Clinical Trial Controlled Clinical Trial
A comparative study of IPPB, the incentive spirometer, and blow bottles: the prevention of atelectasis following cardiac surgery.
Following cardiac operations, 145 patients were treated with either intermittent positive-pressure breathing (IPPB), blod bottles, or an incentive spirometer in an attempt to alter the incidence of atelectasis. Pulmonary complications occurred in 30% of the patients receiving IPPB, 15% of those using an incentive spirometer, and 8% of those using blow bottles. ⋯ The cost of IPPB is also considerably greater than either incentive spirometry or blow bottles. IPPB is not essential to prevention of atelectasis in postoperative cardiac surgical patients and may be inferior to other methods.
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Forty-six episodes of pulmonary infection occurred in 41 patients during a seven year period in which 187 renal transplants were performed in 168 patients. Thirty-seven episodes followed 152 cadaveric transplants (24.39%), and four episodes followed 35 living related donor transplants (11.4%). Five patients had two episodes of pulmonary infection. ⋯ Transtracheal aspiration with Gram stain and direct sensitivity plating routinely provided early and accurate identification of the organism and a guide for therapy in bacterial infections. Pulmonary infection in renal transplant recipients is associated with a high mortality rate. Early diagnosis and specific treatment are essential to successful management.