Articles: postoperative-complications.
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Ileostomy function was studied in 12 patients with an established ileostomy following proctocolectomy, in 6 of whom minimal amounts (less than 9 cm) and in 6 significant amounts (30-120 cm, mean 60 cm) of terminal ileum had been removed. Patients who had undergone significant ileal resection had daily faecal volumes considerably greater than those with minimal ileal resection (1202 +/- 284 ml versus 401 +/- 92 ml, P less than 0.001), and also greater daily outputs of sodium (146 +/- 53 mEq versus 43 +/- 12 mEq) and potassium (12.7 +/- 9.0 mEq versus 4.0 +/- 0.99 mEq). ⋯ It is concluded that when recurrent inflammatory bowel disease, partial small bowel obstruction and intraperitoneal sepsis have been excluded there remains a number of patients whose high ileostomy output is due entirely to the amount of ileum resected. The management of patients with a high output ileostomy with codeine phosphate, Lomotil and oral administration of sodium chloride tablets is discussed.
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Clinical Trial Controlled Clinical Trial
Editorial: Low-dose heparin prophylaxis for postoperative venous thromboembolism.
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Thoraxchir Vask Chir · Aug 1975
[Acute left heart failure following repair of atrial septal defects. Its treatment by reopening].
Among 716 patients operated on for an ASD, 15 of them, following closure of the defect, developed acute left heart failure requiring partial re-opening. The most prominent anatomical finding in these cases was hypoplasia of the left ventricle. ⋯ Therefore, a marked difference of the stroke work of the left and right ventricle, respectively, appeared to be the essential underlying hemodynamic mechanism. The prognosis has been found to depend mainly on prompt surgical intervention; so in all poor-risk cases continued monitoring of left atrial pressure is indicated for early detection of impending left heart failure.--The high incidence of left heart failure as cause of death after repair of an ASD indicates the importance of this complication.
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Anesthesia and analgesia · Jul 1975
Comparative StudyEffects of intraoperative PEEP on postoperative arterial oxygenation.
Previous studies have suggested that early postoperative hypozemia may be due to a reduction of functional residual capacity (FRC) during anesthesia and surgery. Positive end-expiratory pressure (PEEP) has been recommended as a means of maintaining FRC and improving arterial oxygenation. ⋯ Patients receiving PEEP maintained the highest mean Pao2 intraoperatively. However, the beneficial effect of intraoperative PEEP was not sustained in the recovery room, where all patients experienced the same degree of arterial hypoxemia.
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The American surgeon · Jul 1975
Adult respiratory distress syndrome in postoperative patients: study of pulmonary pathology in "shock lung" with prophylactic and therapeutic implications.
Lungs of 44 patients who died after postoperative respiratory distress and shock had a significantly higher incidence of atelectasis and thromboembolism than did 31 control patients. However, both lesions were as inconstant in occurrence as all other 15 investigated pulmonary changes. ⋯ While possibly a contributing factor, shock is not the most important cause of the pulmonary lesions in postoperative patients. The term "shock lung" should be eliminated and renewed emphasis should be placed on detection, prevention and treatment of the pathogenic mechanisms involved in each individual case.