Hemodynamic benefit of optimizing atrioventricular delay after cardiopulmonary bypass.

Background: Shortening of atrioventricular delay (AVD) by sequential cardiac pacing has been proposed to improve hemodynamics in patients with end-stage heart failure. In addition, optimization of prolonged AVD may be associated with a decrease of presystolic mitral insufficiency. The aim of this study was to explore the incidence of prolonged AVD during the early postcardiopulmonary bypass (CPB) period and to evaluate the hemodynamic benefit of its shortening by using sequential cardiac pacing.

Infected abdominal aortic aneurysm associated with a psoas abscess, aorto-duodenal and sigmoid fistulas. Case report and review of the literature.

A case of atherosclerotic abdominal aortic aneurysm, complicated by aortoenteric fistulizations and infected by Escherichia coli, is presented. Chronic contained rupture resulted in the formation of a huge left psoas abscess which was responsible for the symptoms. No similar case has been reported in the literature.

Propofol-alfentanil versus fentanyl-midazolam in coronary artery surgery.

Objective: To compare intraoperative hemodynamics profiles and recovery characteristics of propofol-alfentanil with fentanyl-midazolam anesthesia in elective coronary artery surgery.

Design: Prospective, randomized study.

Setting: University hospital.

To control or to be controlled? From health locus of control to morphine control during patient-controlled analgesia.

We postulated that patients with an internal locus of control, i.e. those who like to control their health problems themselves, would adapt more adequately to the 'patient-controlled analgesia' technique as compared to patients with an external health locus of control, who do not believe in their own control.

Neuralgia following lumbar sympathectomy.

Between March and October 1986, 33 consecutive patients underwent unilateral lumbar sympathectomy in the Thoracic and Cardiovascular Surgical Unit of the Catholic University in Louvain, Belgium. Ten patients experienced postsympathectomy neuralgia. After a single epidural injection of fentanyl, 50 micrograms, and methylprednisolone 80 mg, pain disappeared completely in six patients.

Safety of central venous catheter change over guidewire for suspected catheter-related sepsis. A prospective randomized trial.

We conducted a study to determine the safety of guidewire exchange of central venous catheters suspected of causing catheter-related sepsis (CRS). Out of a total of 146 patients studied prospectively 41 (28%) suspected of having CRS, were randomly allocated to have their catheters changed over a guidewire (group I) or replaced by a new contralateral venipuncture (group II). One hundred and five patients (group III) requiring only one catheterization served as a control group.

Intravenous infusion of propofol for induction and maintenance of anaesthesia during endoscopic carbon dioxide laser ENT procedures with high frequency jet ventilation.

Fourteen patients of ASA grades 1-3 were anaesthetised with continuous infusions of propofol and alfentanil for endoscopic carbon dioxide laser ENT microsurgery. Their lungs were ventilated with an oxygen-air mixture using a high frequency jet ventilator. Propofol was given at an initial rate of 120 micrograms/kg/minute for 10 minutes after a bolus dose of 2.

Halothane versus isoflurane for short ENT procedures with spontaneous respiration in children.

This study compares halothane with isoflurane for short ENT procedures performed under spontaneous breathing in 80 children. Monitoring included ECG, arterial pressure, PECO2 and respiratory rate. Induction, maintenance and recovery durations were recorded.

Cryoanalgesia for post-thoracotomy pain relief.

A randomized study comparing the postoperative requirements of narcotics of three groups of patients (Group I: no analgesia; Group II: internal intercostal nerve block; Group III: cryoanalgesia) was conducted. This study was performed in order to assess the efficiency of cryoanalgesia versus internal intercostal nerve block to obtain pain relief after thoracotomy. Regarding post-operative narcotic requirements (Piritramide-Dipidolor), there was no significant difference between Group I and Group II patients, but patients from Group III required a significantly lower amount of narcotics during the first 36 postoperative hours (p less than 0.

Pulmonary edema following acute upper airway obstruction.

During recovery, our patient presented an acute upper airway occlusion. After the removal of the airway obstruction, he developed a massive bilateral pulmonary edema with an acute hypoxemia. Hemodynamic measures following this incident show that mean and wedged pulmonary pressures are in the normal ranges.