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F Guillén Ramírez

Publications and source records attributed to F Guillén Ramírez.

10 recordsLinked to original sources
PubMed1991

[Complications of liver transplant in intensive care. Experience in 130 cases].

Liver transplant is the first therapeutic choice in most of the advanced liver diseases. Nevertheless, its performance originates a number of complications derived from: a) conservation techniques of the organ (in our study a prolonged time of hot ischemia was significantly associated with); b) surgery (all patients who required massive blood transfusions developed metabolic alkalosis); c) the graft itself (all the F 1. degrees were significantly infected), and d) extrahepatic causes (cyclosporin was responsible for high blood pressure and nephrotoxicity which appeared as oliguria with good response to furosemide, as well as hyperglycemia). Some other relevant results in our series were: right pleural effusion and thrombopenia which appeared with a high incidence. Infections were usually originated the staphylococcus which grows in half of the cultures. We also want to highlight the short mean stay and the low mortality incidence in the ICU.

Adult↗
PubMed1991

[Massive hemothorax: an exceptional complication of Rendu-Osler-Weber disease].

Hereditary familial telangiectasis is a vascular dysplasia characterized by a triple syndrome: hereditary character, telangiectasias and hemorrhages. Its association with systemic and/or pulmonary arterio-venous fistulae is frequent and can condition several complications: cerebral abscess, digestive hemorrhages, epistaxis, hemoptysis, hypoxemia, polyglobulia, and rarely the appearance of hemothorax. We describe a patient who was admitted in hospital with a hypovolemic shock secondary to a massive hemothorax; during emergency surgery, which was necessary to perform, a pulmonary A-V fistula was observed in the middle lobe. The studies afterwards performed demonstrated that it was a Rendu-Osler-Weber disease with duodenal, hepatic, and cerebral involvement.

Adult↗
PubMed1989

[Reduction of transfusion needs by the early introduction of venovenous bypass in liver transplant].

A study was made of 44 patients who underwent liver transplant, distributed into three groups: Group A: patients who had ample liver dissection before entering bypass. Group B: patients who entered bypass after dissection of the hepatic hilum and prior to any other dissection; bypass time was prolonged for meticulous hemostasia. Group C: patients with perfectly defined hemodynamic problems, not secondary to bleeding, during the anhepatic phase. Preoperatively the three groups were homogeneous as regards clinical situation. During the operation a significantly larger transfusion volume (p less than 0.01) was administered in group C during phase II (70.1 +/- 27.2 ml/kg/h), phase III (32.6 +/- 9.6 ml/kg/h) and throughout surgery (32.7 +/- 10.3 ml/kg/h) than in the other two groups. Group B received a smaller transfusion volume during phase II (14.6 +/- 8.1 ml/kg/h), phase III (12.7 +/- 5.5 ml/kg/h) and throughout surgery (11.6 +/- 4.9 ml/kg/h) than the other two groups (p less than 0.01). The transfusion needs of group A were 28.4 +/- 15.6 ml/kg/h in phase II, 26.8 +/- 17.1 ml/kg/h in phase III and 21.2 +/- 11.2 ml/kg/h throughout surgery. The duration of the anhepatic phase was significantly shorter (p less than 0.01) in group A (1 h 10' +/- 10) than in (1 h 50' +/- 10) and C (1 h 40' +/- 45'). In the postoperative period a higher mortality was associated with group C (37.5%) and a lower mortality with group B (3.33%), the mortality of group A being 16.6%. The differences were statistically significant with p less than 0.01.

Adult↗
PubMedDate not supplied

[Pulmonary atelectasis in bent lateral decubital position (nephrectomy). Apropos of a case].

Here we have the case of a right nephrectomy ureterectomy for urothelial neoformations in the upper urinary apparatus, in the position of a left flexed lateral decubitus (nephrectomy) practised to a patient, in which a small right pleural aperture was unnoticed until the end of the operation when the closing was being carried out. In the immediate postoperative, the patient developed hypoxia and hypercapnia, as well as an atelectasis of the lower lobus in the left lung, that appeared in the radiological test. We comment now the causes that could have originated this picture, such as overweight, the position of the patient during the operation, its length and the pleural aperture throughout the surgical act, focusing the study in this latter point.

Humans↗