The paper discusses the substantial reduction in weight and volume of the fluids of resuscitation that is possible and desirable on the basis of sound physiology and the vast experience of the U.S. Army in four major wars in this century. We note the major shift in emphasis from massive colloid and whole blood in World War II and Korea to massive crystalloid and packed cells in Vietnam and the serious complications with which this was associated. These complications were edematous in nature and best known as the Da Nang lung, or adult respiratory distress syndrome, multiorgan dysfunction syndrome, and systemic inflammatory response syndrome. The advantage of colloid in reducing the weight and volume of resuscitation fluids in forward areas by 60% to 90%, as well as in avoiding the edematous complications of crystalloid-, are emphasized.

Adult↗

PubMed1994

ARDS and Ockham's razor.

Explore the source record for details and available documents.

Capillary Permeability↗

PubMed1978

Ruptures and perforations of the esophagus: the case for conservative supportive management.

A series of 31 patients treated for ruptures and perforations of the intrathoracic esophagus is reviewed. Eighteen of these patients underwent major thoracotomy; 11 were treated with minor procedures. Two died before treatment could be implemented. Of the 18 undergoing major operations, 7 died; among the 11 managed conservatively there was only 1 death. Based on this experience, we conclude that major surgical repair for esophageal perforation is often unnecessary. It has the additional drawback of sometimes resulting in equally serious secondary procedures.

Esophageal Diseases↗

PubMed1976

Leiomyomata of the esophagus. An analysis of 838 cases.

Review of the world literature to the end of 1971 has provided data on 838 cases of esophageal leiomyomata, including our own 19 surgically removed lesions. Although esophageal leiomyoma is the most common of the benign tumors of the esophagus, it is still rare compared with carcinoma. It occurs in more men than women, by a ratio of 1.9 to 1. Over 50% of the patients with leiomyoma of the esophagus are asymptomatic. Dysphagia and vague pain are the most frequent symptoms. Pyrosis is mentioned in the literature as present in 40% of the cases, but it is considered mainly as symptom of coexistent hiatal hernia. Diagnostic problems often arise, as the smooth muscle tumors may mimic mediastinal neoplasms, cysts, or even aneurysms, or complicate coexisting hiatal hernia and esophageal diverticulum. Operative management by transthoracic enucleation is the procedure of choice, although resection of the esophagaus may be required in few cases. Postoperative morbidity is minimal and results are excellent.

Adult↗

PubMed1973