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J. K. Kang Sang Won Lee Min Woo Baik Byung Chul Son Yong Kil Hong Chul Ku Jung Keon Hee Ryu 《Child's nervous system》1998,14(7):297-301
Accurate assessment and replacement of blood loss and fluid–electrolyte deficit during craniosynostosis repair is difficult
owing to patient size and the diversity of surgical technique. Forty-three patients undergoing primary craniosynostosis repair
over a 10-year period were studied retrospectively to determine blood loss and fluid deficit and to assess blood transfusion
practices during both intraoperative and postoperative periods. Blood loss was calculated on the basis of estimated red cell
mass (ERCM) and fluid-electrolyte imbalance was investigated with blood samplings. Blood transfusion was considered appropriate
if the postoperative or posttransfusion ERCM was within 12% of the preoperative value. Estimated fluid requirement (EFR) was
used in 4 ml kg–1 h–1 except for neonates. Intraoperatively, 80% of all patients were appropriately managed with respect to blood transfusion and
EFR. Postoperatively only 20% of the patients receiving transfusions were transfused appropriately. In 23.3% of these patients
(10/43) unexpected respiratory distress developed immediately after their recovery from the anesthesia. With the measurement
of estimated blood volume and allowable blood loss, appropriate transfusion could be achieved for the successful treatment
of the primary craniosynostosis.
Received: 16 February 1998 相似文献
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Adverse reaction to intravenous gadoteridol 总被引:1,自引:0,他引:1
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Summary Treatment of cancer of the cervical aerodigestive tract is challenging due in part to the difficulty in reestablishment of pharyngoesophageal continuity after resection of the involved tract. From May 1989 to August 1990, six patients underwent immediate reconstruction utilizing microvascular transfer of free radial forearm flaps following resection of pharyngoesophageal neoplasms. A small island flap connected to the radial vascular pedicle by fasciocutaneous branch was used to monitor the vascular condition of the hidden fabricated free forearm flap. Stricture is the most troublesome complication of esophageal reconstruction using a conventional free forearm flap. Two small triangular flaps were designed and inserted bilaterally in the distal anastomosis of both lateral esophageal walls to prevent circular contracture. The outer layer sutures were anchored to surrounding rigid structures to withstand shrinkage and circular contraction. The problem of stricture was solved by these procedures. This one-stage, easily monitored operation for pharyngoesophageal reconstruction is considered to be as useful as a free jejunal transfer. 相似文献
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