Influence of brachial plexus blockade on oxygen balance during surgery.

The combined effects of anesthesia, motor blockade, and chemically induced sympathectomy after brachial plexus blockade can have a beneficial impact, when applied in selected, isolated diseased states of the upper limb. With the aim of using the prolonged effects of brachial plexus blockade for a future therapeutic application, we demonstrated a dependable methodology of venous blood gas monitoring and confirmed an improved oxygen balance of the blocked versus nonblocked upper extremity in a controlled, prospective study in healthy patients undergoing elective hand surgery.

Which of the abbreviated burn severity index variables are having impact on the hospital length of stay?

Quality control is an important tool ensuring continuous medical efficacy. Outcome scores, however, are unfavorable from a statistical point of view, are not meaningful for less severely injured patients, and may put the treating physicians under pressure to limit therapeutic efforts. In this study the variables of the abbreviated burn severity index (ABSI), primarily an outcome score, were used to predict length of hospital stay (HLS), a continuous quantitative variable reflecting treatment costs and incidence of complications even in less severely injured patients.

Evaluation of skin perfusion by use of indocyanine green video angiography: Rational design and planning of trauma surgery.

Background: A very important aspect in the treatment of traumatic injuries is to determine the extent of skin involvement. Traditionally, this has involved clinical examinations, a more or less subjective technique. Therefore, various techniques, supplementing the clinical diagnosis, have been suggested, but none has yet achieved widespread clinical acceptance.

Postoperative vigilance in patients with total intravenous anaesthesia with ketamine/propofol.

Ketamine is a strong acting analgesic drug, used mainly in trauma and emergency medicine settings, as well as for minor procedures. Its pharmacological properties make it a useful drug for military anaesthesia. Ketamine acts by blocking activation of the spinal and supraspinal NMDA-type glutamate and opioid receptors.

Impact of intraoperative duodenal feeding on the oxygen balance of the splanchnic region in severely burned patients.

Enteral feeding causes an increase of intestinal oxygen demand depending on the amount administered. The aim of this study presented was to evaluate, whether intraoperative duodenal feeding might put patients at risk developing splanchnic O(2)-imbalance due to an intraoperatively compromised intestinal perfusion based on stress and unrecognized hypovolemia. In 18 severely burned patients, the CO(2)-gap between the arterial and gastric CO(2), as a parameter for the intestinal O(2)-balance, was measured during the first operation.

Active warming of critically ill trauma patients during intrahospital transfer: a prospective, randomized trial.

Objective: Hypothermia in trauma victims is a frequently observed phenomenon in acute care. Known complications of hypothermia are impaired wound healing, cardiac complications, hemodynamic instability, impaired immune function and increased blood loss. We compared active warming versus passive warming in hypothermia in critical-care patients undergoing intrahospital transfer from ICU to computer tomography (CT).

Serum cholesterol and triglycerides: potential role in mortality prediction.

The present study was performed in order to evaluate the diagnostic usefulness of serial cholesterol and triglycerides measurements in patients with severe burns. One of the main objective was to find out if these parameters are clinically relevant to determine the morbidity of a burn patient and thereby the patient's outcome. In 220 patients with thermal injuries, cholesterol and triglyceride concentrations were measured daily.

Nutrition and anabolic agents in burned patients.

Purpose Of Review: Much of the morbidity and mortality of severely burned patients is connected with hypermetabolism and catabolism with its accompanying impairment of wound healing and increased infection risks. In order to prevent the erosion of body mass, nutritional support and other strategies to prevent catabolism have become a major focus in the care of severely burned patients.

Recent Findings: Major themes discussed in recent literature are dealing with enteral versus parenteral nutrition and gastric versus duodenal feeding.

Serum cholinesterase activity in patients with burns.

Serum cholinesterase activities were measured in 300 patients with thermal injuries. The samples were drawn immediately upon admission and thereafter daily until the time of the patients' discharge or death. According to the burn severity a characteristic decrease was noted during the first days.

Impact of duodenal feeding on the oxygen balance of the splanchnic region during different phases of severe burn injury.

Enteral nutrition is recommended in burned patients. Depending on the amount administered, enteral feeding causes an increase of intestinal oxygen-demand. Since intestinal perfusion is decreased after major burns the aim of this study was to evaluate, whether duodenal feeding might be a cofactor for the development of a splanchnic O(2)-imbalance.