N Bertrán | PubMed Health

PubMed1997

[Systemic capillary leak syndrome].

The systemic capillary leak syndrome is a rare condition, with a high mortality rate, characterised by recurrent episodes of generalized edema, with hemoconcentration and hypoproteinemia, associated with paraproteinemia. Pathophysiologically, this syndrome is caused by a sudden, reversible increase in capillary permeability, with a rapid shift of plasma from the intravascular to the extravascular compartment with subsequent hypovolemic shock. We report a new patient of this unusual condition, and we review its diagnostic and therapeutic aspects.

Capillary Leak Syndrome↗

PubMedDate not supplied

[Omeprazole in the prophylaxis of Mendelson syndrome in elective surgery].

AIMS: To study the efficacy of different doses of omeprazole and the influence of premedication in the prophylaxis of the acid aspiration syndrome. METHODS: A double blind prospective study was carried out ASA I-III on 103 patients (mean age 51.08 yr) undergoing either general, gynecological or orthopedic surgery, allocated into 4 groups. Group NP: 24 non premedicated patients; group P: 29 patients premedicated with 1 mg of lorazepam the previous night and 50 mg of meperidine 1 hour before surgery and haloperidol or dipotassic chlorazepate according to age; group 020: 25 patients premedicated with the same drugs and doses as in group P plus 20 mg or oral omeprazole the night prior to surgery; group 040: 25 patients premedicated as in group P 40 mg of oral omeprazol the night prior to surgery. Following induction of anesthesia a nasogastric tube was placed and gastric juice withdrawn to determine the pH; were excluded patients with an aspiration volume of less than 8 ml. RESULTS: No significant differences were found in regard to pH among the non premedicated and premedicated groups, however a change between the latter two groups having received omeprazole was observed. The results of the pH were significantly higher in the group treated with 40 mg of omeprazole (mean 4.87 +/- SD 2.35) with respect to the group treated with 20 mg of omeprazole (mean 3.78 SD +/- 2.35). In the group treated with 40 mg of omeprazole, the incidence of pH < 1.5 was 4% vs 24% of cases in the group treated with 20 mg of omeprazole. CONCLUSIONS: Premedication with 40 mg of oral omeprazol the night prior to surgery increases pH up to safe values for the prophylaxis of the acid aspiration syndrome.

Adult↗