Trauma management during tragic years of lebanon part iii

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Transcript of Trauma management during tragic years of lebanon part iii

Post PneumonectomyPulmonary Edema

1. Right Pneumonectomy. 2. Acute lung injury.3. Fluid overload4. Pulmonary hypertension complicated by

right ventricular failure. 5. Unbalanced post operative chest

drainage

Con: Continues Blood Monitoring Should Not Be A Standard During Cardiopulmonary Bypass

Robert G.Merin

Finally, I find it somewhat peculiar that my worthy opponent, Dr Anis Baraka, should be arguing in favor of this expensive high technology piece of equipment. All of us in

anesthesia and surgery who are acquainted with Dr Baraka marvel at his ability to continue practicing high quality anesthesia through the ravages of the war in Beirut,

Lebanon. In addition, the fact that he has been able to continue to publish high-quality scientific investigations in the face of an almost untenable situation is a tribute to his

talents and courage. However, it seems to me extremely unlikely that Dr Baraka's hospital could consider the initial expense of this piece of equipment or the probable

maintenance costs. I would hope that the abusive medical and legal climates that exist in the United States will not sp read to Europe and the Middle East.

CONTINUOUS BLOOD GAS MONITORING SHOULD BE A STANDARD DURING CARDIOPULMONARY BYPASS

Pro: Continuous Venous Oximetry Should Be Used Routinely DuringCardiopulmonary Bypass

Anis Baraka, MBBCh, DA, DM, MD, FC Anesth

PRO AND CONJ,Earl Wyands, MD, Editor

TACHYPHYLAXIS TO CISATRACURIUM- Case Reports and Literature Review -

Critical Illness Multiple Neuropathy and/ or Myopathy

Bone et al. Chest 1992;101:1644

SIRSINFECTION

PANCREATITIS

BURNS

TRAUMA

OTHER

SEPSIS

SEVERESEPSIS

SEPTICSHOCK

SIRSWidespread inflammatory response, >=2

Temperature > 38°C or < 36°CHeart rate > 90 beats/ minRespiratory rate of > 20 breaths/ min or PaCO2 < 32mmHgWBC >12,000 , <4000 cells/ mm3 or >10% bands

SEPSISSystemic response to infection(SIRS + Infection)

SEVERE SEPSISSepsis associated with organ dysfunction, hypoperfusion, or hypotension

SEPTIC SHOCKSepsis with hypotension and hypoperfusion despite adequate fluid resuscitation

Treatment