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  • 1
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    Anaesthesia 47 (1992), S. 0 
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: A postoperative cardiac surgical patient developed ventricular fibrillation immediately after accidental pericardial injection of bupivacaine at room temperature. The possible causes, which include systemic toxicity, local vasoconstriction with myocardial ischaemia, local toxic effect of bupivacaine or local hypothermia, are discussed.
    Type of Medium: Electronic Resource
    Library Location Call Number Volume/Issue/Year Availability
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  • 2
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The value of monitoring the right precordial lead, V4R, to detect peri-operative ischaemic events during coronary artery surgery was studied in 60 patients. Thirty-four patients had only left-sided coronary disease (Group I). The other 26 patients had both left-sided occlusive coronary artery disease and significant right-sided occlusive lesions on coronary angiography (Group 2). Lead sensitivity was estimated, assuming that all ST segment changes were true positive responses. Sensitivity using a single lead was greatest for lead V5 in the two groups (73% for Group I and 69% for Group 2). Sensitivity in Group I for lead II was intermediate (55%), whereas sensitivity for lead V4R was only 9%. In Group 2, on the other hand, lead V4R was 54% sensitive and lead 11 only 31%. The combination of leads V4R and V5 increased the sensitivity to 92% in Group 2, whereas lead II or V5 combined with V4R failed to improve sensitivity in Group 1. The monitoring of lead V4R allowed detection of 23% of the ischaemic episodes in Group 2 that would have passed undetected if only lead II and V5 were monitored. These results demonstrate the value of an additional right precordial lead during coronary artery bypass grafting in patients with right-sided occlusive disease.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1432-1238
    Keywords: Labetalol ; Head injury ; Blood gas data ; Haemodynamics ; Systemic, pulmonary ; Pulmonary ; Shunting, mechanics
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The arterial oxygen and carbon dioxide tensions, pulmonary and systemic haemodynamics and pulmonary shunting and mechanics were measured during the first 30 min after intravenous labetalol administration. Thirty patients, recovering in the intensive care unit after neurosurgical interventions were randomly divided in 2 groups of 15 patients, receiving either labetalol or placebo. In the labetalol treated group the arterial oxygen tension decreased from 553.6±16.8 to 529.3±19.8 mmHg 5 min after the injection of labetalol. A concomitant increase in arterial carbon dioxide tension from 40.1±1.1 to 45.5±1.3 mmHg was noticed. Pulmonary vascular resistance decreased from 159.6±14.7 to 116.7±11.7 dynes·sec·cm-5 and pulmonary shunting increased from 4.8%±1.4% to 8.1%±2.4% 5 min following injection. All these changes were statistically significant for p〈0.01. After 30 min all values had returned to their initial level. No changes were registered in the control group. As airway resistance appeared not to be affected by the labetalol administration it may be concluded that the observed changes in blood gas data are most likely due to a transient decrease of the pulmonary vascular resistance with a concomitant increase in pulmonary shunting.
    Type of Medium: Electronic Resource
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