Articles: postoperative-complications.
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Clinics in chest medicine · Jun 1990
ReviewInfectious complications in pulmonary allograft recipients.
This article has outlined the features of the major types of infections encountered in pulmonary allograft recipients. Virtually any pathogen can cause infection in these immunocompromised subjects, and there is a distinct propensity for these organisms to invade the transplanted lung. As is the case with other major organ recipients, there is a temporal sequence in the types of infection lung allograft recipients contract. ⋯ Despite these relative successes, however, the risk for infection of the allograft remains high because the defense mechanisms in the lung allograft are breached by the effects of surgery, the "allogeneic environment" in the allograft and systemic immunosuppression, and the fact that chronic rejection causes structural changes that predispose to bacterial colonization of the airways and the need for increased levels of immunosuppression. Despite the formidable barrier that infection of the lung allograft poses, the procedure of pulmonary transplantation clearly holds sufficient promise that all efforts possible should be made to hurdle this barrier. Achieving such a goal would ensure a place for pulmonary transplantation in the armamentarium of treatment for irreversible pulmonary disease.
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As the number of elderly patients undergoing surgery increases, postoperative confusion becomes an increasingly encountered problem. Postoperative confusion has long been recognized as a specific entity, but the etiology and risk factors have not been well defined. To make the diagnosis promptly, the physician must maintain a high index of suspicion. This review provides a series of brief mental status tests that can be administered quickly at the bedside and outlines a specific approach to treatment.
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J Paediatr Child Health · Apr 1990
Review Case ReportsRecurrent tracheo-oesophageal fistula: experience with 24 patients.
Over an 11 year period, 275 infants with oesophageal atresia and tracheo-oesophageal fistula were treated. Of these, 22 (8%) developed a recurrent fistula. ⋯ Once the diagnosis of a recurrent fistula has been firmly established, operative repair should be undertaken. In our series of 24 patients, there were three deaths (12.5%), four patients developed a second recurrence (16.6%), while a secondary oesphageal replacement was carried out on five patients.
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Pulmonary edema developing after the relief of upper airway obstruction has been reported in association with a diversity of etiologic factors, including hanging, strangulation, tumors, foreign bodies, goiter, and laryngospasm. Since 1977, 18 cases of adults with postobstructive pulmonary edema associated with anesthesia have been reported. ⋯ Risk factors for the development of upper airway obstruction have been identified in the majority of these cases. A heightened awareness among anesthesiologists of this poorly recognized and hence often perplexing syndrome may help reduce the occurrence and facilitate the treatment of this potential complication of perioperative airway management.
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Langenbecks Arch Chir Suppl II Verh Dtsch Ges Chir · Jan 1990
Review[Diagnosis and monitoring of postoperative pulmonary complications].
There is no distinct difference between regular postoperative pulmonary changes and postoperative pulmonary complications (PPC). Beside the "classic" PPC, atelectases and bronchopneumonia, adult respiratory distress syndrome (ARDS) and barotraumas are becoming of increasing importance. ⋯ The varieties of germs found in bronchial secretions and lung parenchyma, however, are not considerably different. CAT scan seems to be the best diagnostic imaging tool for the follow-up of ARDS and barotrauma.