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At least 19 recordsLinked to original sources
PubMed1990

Temperature problems in the postoperative period.

Postoperative patients have difficulty maintaining thermal balance for several reasons. Normal thermoregulation is suppressed by anesthesia, neuromuscular blocking agents, and other drugs, and cool environmental conditions and exposure contribute to heat loss. Specific patient groups at high risk for hypothermia include infants, the elderly, and the neurologically impaired. Temperature drift, afterfall, shivering, malignant hyperthermia, and fever are among the temperature-related conditions requiring vigilant assessment and nursing action during the postoperative period.

Body Temperature Regulation↗
PubMed1979

Echocardiographic studies of children operated on for congenital heart disease; evaluation in the immediate postoperative period.

In the immediate postoperative period, echocardiography was used to study left ventricular function in 69 children after correction of various congenital cardiac malformations. Left ventricular contractility indices and systolic time intervals measured from aortic cusp echoes were repeatedly obtained during the fist postoperative week. The degree of impairment of left ventricular function was assessed for different diagnostic groups and are tabulated. Decrease in left ventricular function was strongly correlated to operating time, cardiac bypass time, and aortic clamping time, the most important factor being cardiac bypass time. Left ventricular ejection time (LVET) was the most useful parameter of cardiac function in the immediate postoperative period and was of prognostic value in 5 patients who died early in that period. Abnormal septal movement was seen in most patients, but usually normalized within 2 wk. After extensive operations, changes in the movement pattern of the aortic leaflets were also seen. Although pericardial effusion was commonly found during the postoperative period, it did not indicate postcardiotomy syndrome and disappeared spontaneous within 2 mth.

Adolescent↗
PubMed1989

[Influence of the pathogenetic variant of uterine cancer on the dynamics of prolactin secretion in the early and late postoperative periods].

In early postoperative period, patients with uterine carcinoma of pathogenetic types I and II developed hyperprolactinemia with similar frequency. However, elevation of prolactin concentration was found to vary with pathogenetic type. For type I endometrial carcinoma, prolactin level on postoperative days 1-5 was twice those registered in type II tumor. Later, prolactin levels returned to normal.

Adenocarcinoma↗
PubMed1978

[Immunological changes during the immediate postoperative period (author's transl)].

Postoperative variations in the different parameters of humoral and cellular immunity were studied in 18 adult patients in general surgery. Levels of immunoglobulins G (igG) fell and those of immunoglobulins M (igM) increased significantly. Lymphocytic proliferation under the influence of PHA showed a significant fall. Neither polynuclear function nor total complement activity were modified. Patients in whom the postoperative course was complicated by sepsis differed from the others by a lower activity of the lymphocyte transformation test and by a higher level of igG and igM on the day prior to surgery. In addition, deficiency in the lymphoblastic transformation test increased during the postoperative period, there was a further fall in IgG and IgM increased less in these patients than in those in whom the postoperative course was uncomplicated.

Adult↗
PubMedDate not supplied

[Changes in hemostasis in the postoperative period].

Hemostasis was investigated in the postoperative stage (at 24 hours and at 5 days) in 20 patients that had underwent major surgical interventions. The test applied for study of blood coagulation included : thrombocyte counting, the test of Howell, the activated recalcification time, the activated partial thromboplastin time, the prothrombin time (Quick), the thrombin time, estimation of fibrinogen concentration, the protamine sulphate test. The activity of the fibrinolytic system was investigated by the euglobulin clot lysis test and by the method of fibrin plates, while fibrinolysis inhibitors were assessed by determination of serum antiplasmines. Also the fibrinolytic degratation products were evaluated. The results indicate a biological condition that can be classified as "thrombophilia", characterized by hyperfibrinogenemia, the presence of fibrin monomers, a decrease of the fibrinolytic activators and an increase in the amount of antiplasmins, as well as a high percentage of fibrinolytic degradation products. Although the patients did not show manifest signs of thrombosis in the postoperative period, the results obtained indicate a tendency to intravascular formation and deposition of fibrin and suggest the necessity to apply prophylactic therapy with anticoagulants in the postoperative period.

Anticoagulants↗
PubMed1978

[Postoperative period in previously irradiated lung cancer patients].

The postoperative period in 62 patients with lung cancer was studied in a comparative aspect. Preoperative use of radiotherapy influences but insignificantly the postoperative course. As a whole, the incidence of postoperative complications and mortality does not differ considerably from that in patients not irradiated with a Betatron. The state of blood coagulation was studied before and prior to surgery in 34 patients previously irradiated with a Betatron. Following the irradiation some changes indicative of hypocoagulation were revealed. In the early postoperative period (2d--10th day postoperatively) a marked increase in the fibrinogen "A" content is observed.

Blood Coagulation Disorders↗
PubMedDate not supplied

[The concentrations of somatotropic hormone and insulin in the blood of heart surgery patients with a complicated course of the postoperative period].

It has been shown that the course of the early postoperative period in cardiosurgical patients and its outcome is to a great extent related to adequate balance of adaptation hormones, whose levels and changes are determined by the functional state of compensatory-adaptive systems. Patients with favourable outcome of the complicated postoperative period along with synchronous activation of sympathoadrenal system (SAS), hypophyseoadrenal system (HAS) and an elevated somatotropic hormone (STH) level demonstrated adequately high blood insulin content, with the equilibrium in adrenalin/insulin and cortisol/insulin ratios retained, and moderate STH predominance over insulin. In 1/4 of patients with complicated postoperative period and unfavourable outcome an attenuated SAS response was accompanied by excessively high STH, ACTH, cortisol blood content and a lower insulin level, which determined relative insulin insufficiency.

Adolescent↗
PubMedDate not supplied

[The Bohr effect during an uncomplicated course of the early postoperative period in heart surgery patients].

48 patients have been examined in the early postoperative period after open heart surgery (25 patients after correction of acquired heart valve defects and 23 patients after aortocoronary bypass surgery on 2-6 coronary arteries). Gas exchange parameters, hemodynamics, hemoglobin, gases, acid-base balance were studied and P50 was determined with the Severinghaus blood gas analyzer. Using a multidimensional regression analysis, the regularities of P50 changes in uncomplicated postoperative period have been investigated (namely coefficients of temperature and Bohr's shifts of oxyhemoglobin dissociation curve have been studied). It has been shown that the main factors responsible for P50 changes in patients with uncomplicated postoperative period are Bohr's effect (i. e. the impact of pH and pCO2) and the body temperature. With pH and T changes, the coefficients were close to classical ones: -0.37, -0.42 and 0.035, respectively. In Bohr's effect the coefficient, as determined by multidimensional regression analysis, was not very reliable, which was due to its low value (about 0.001).

Cardiac Surgical Procedures↗
PubMed1976

CPK-MB isoenzyme: use in diagnosis of acute myocardial infarction in the early postoperative period.

The diagnosis of acute myocardial infarction (AMI) in the early postoperative period may be quite difficult in certain patients. Electrocardiograms fail to be diagnostic of AMI in as many as one third of patients with myocardial injury found at autopsy. Enzyme patterns commonly used to diagnose AMI in patients admitted to coronary care units are obscured by muscle injury, medications, cardioversion, surgical manipulation, and blood transfusion. The MB isoenzyme of creatinine phosphokinase (CPK) has been described as a specific indicator of myocardial injury. Therefore the CPK-MB isoenzyme level was evaluated as a potential aid in the diagnosis of AMI in the early postoperative period. Thirty patients undergoing cardiac surgery and 7 patients undergoing thoracic surgery not involving the heart were studied. CPK-MB isoenzyme was present in the serum in 10 of 30 patients after cardiac surgery but in none of 7 patients after thoracic surgery. The presence of CPK-MB isoenzyme was found to be a valuable adjunctive indicator in the diagnosis of AMI in the early postoperative period.

Adolescent↗
PubMed1986

[Membrane digestion in the early postoperative period during enteral tube feeding].

The investigation of the membrane digestion has established that in the early postoperative period pronounced alterations of the hydrolytic system in the small intestine take place in all its links (synthesis, translocation and adsorption of enzymes). The main compensatory mechanism responsible for the hydrolytic processes in the early postoperative period is the membrane digestion, so the level of the amylolytic activity of the small intestine in the early postoperative period allows the enteral tube nutrition to be performed not only with mono- and oligosaccharides but also with polysaccharides.

Amylases↗
PubMedDate not supplied

[Changes in the blood glucose of revascularized patients in the immediate postoperative period].

Variability in glycaemia in revascularized patients in the immediate postoperative period was studied in order to determine the presence of hyperosmolar hyperglycaemia coma, ketogenic and non-ketogenic, and the relation with hemodynamic changes. It was found that 15 patients (9.2%) from the Arteriology Service and two patients (7.1%) from the Diabetes Angiopathy Service had a non-ketogenic hyperglycaemic hyperosmolar coma and there was no ketogenic hyperglycaemic hyperosmolar coma. There were 32 patients (16.8%) with hemodynamic changes who had mild and moderate hyperglycaemia in the immediate postoperative period.

Adolescent↗
PubMedDate not supplied

[Central hemodynamics in the early postoperative period following lobectomy and pneumonectomy].

Comparative study of the peculiarities of central hemodynamics before operation and in the early postoperative periods was conducted in 48 patients with lung carcinoma managed by lobe- and pneumonectomy. Lung carcinoma of central localization is characterized by increased contractility of the right-ventricular myocardium. In the postoperative period after pneumonectomy the right ventricle experiences an increased load requiring considerable mobilization of the cardiovascular system. Lobectomy is attended by more marked and less stable changes in the function of the cardiovascular system in the early postoperative period.

Hemodynamics↗
PubMed1990

[Study on changes in extravascular lung water during early postoperative periods in thoracic esophageal cancer--with special emphasis on their relation to postoperative renal function].

Twenty-seven patients with esophageal cancer received an intrathoracic esophagectomy, lymphadenectomy and esophageal reconstruction performed in one stage. They were analyzed for respiratory and hemodynamic function parameters and also observed for the time course of extravascular lung water (EVLW), water balance, renal function as well as colloid osmotic pressure (COP) of plasma. And they were clarified the pathogenetic mechanism of post-operative pulmonary complications mainly from the aspects of pathophysiology of pulmonary edema and functional interrelationship of organs. Two groups of patients, i.e. those undergoing extended lymphadenectomy (particularly for lymph nodes of both sides of neck and upper mediastinum) and those of old age (70 years or above), were investigated for eventual characteristic features of postoperative changes in the parameters mentioned above. In the group of patients with postoperative pulmonary complications, a significant negative correlation was noted to exist between the plasma colloid osmotic pressure-pulmonary artery wedge pressure (COP-PAW) gradient and EVLW and between the former parameter and postoperative renal function (p less than 0.01). A postoperative lowering of renal function observed in the group with postoperative pulmonary complications was due mainly to depressed left ventricular function immediately following operation and assumed to play a significant role in the production of pulmonary edema as a hydrostatic factor subject to the Starling's low. In the group undergoing extended lymphadenectomy, extensive lymph node dissection reduced plasma colloid osmotic pressure. This reduction was thought to bring about a diminution of COP-PAW gradient, produce a transient depression of left ventricular function and augmentation of pulmonary edema, and to stimulate the formation of intrapulmonary shunting. In the old age group, their and renal function depressed immediately after operation because of advanced age. And for the maintenance of cardiac function massive water intake was required. They led to retention of water and thereby played a direct role in the causation of increase in EVLW and in intrapulmonary shunt. All these observations point to the necessity of initiating carefully planned management early in the postoperative period that takes these pathophysiologic features well into account.

Aged↗
PubMed1990

Technical and operative factors in infrarenal aortic reconstruction and their effect on the glomerular filtration rate in the immediate postoperative period and 6 months later.

Renal failure is an important cause of postoperative morbidity and mortality in infrarenal aortic reconstruction. Several mechanisms for this postoperative renal dysfunction have been suggested. However, biochemical testing of renal function is insensitive since it shows only gross renal changes. This study examined prospectively the effects of the technical and operative factors on renal function using radionuclide tests. The authors measured the total Glomerular Filtration Rate (GFR) using 51Cr-EDTA clearance in 59 patients undergoing elective infrarenal aortic reconstruction. We also examined the individual kidneys using 99mTc-DTPA renography and 99mTc-DMSA renal scanning. Renal scanning gives the percentage of function of each kidney, while renography gives a graphic assessment of individual renal perfusion and clearance. All tests were carried out preoperatively, 2 weeks postoperatively and 6 months later. Twelve technical factors including aortic cross clamping time, type of aortic anastomosis, forced diuresis, division of left renal vein and various others were recorded to study their effect on the GFR and the individual kidney function. The effect on renal function of these operative factors has not previously been described. GFR showed no change in the immediate postoperative period. Six months later GFR decreased, the mean decrease was 9 ml/min. (P = 0.007 Wilcoxon rank). Some of our patients showed an increased GFR, a phenomenon that was recognised recently. None of the factors studied, except division of the left renal vein, had any effect on the changes in the GFR in the immediate postoperative period or 6 months later.

Acute Kidney Injury↗
PubMedDate not supplied

[Characteristics of the development of respiratory insufficiency in the early postoperative period following surgery of cancer of the esophagus and the cardia].

Acute respiratory failure (ARF) in the earliest postoperative period after radical surgery for esophageal cancer is characterized by staged development. Its severity is determined by the degree of ventilation-perfusion disorders and the accompanying diffusion disturbances. The following factors are considered to be ARF-provoking: postaggressive circulation centralization, predominant administration of crystalloid plasma substitutes, persistence of hypoproteinemia in the earliest postoperative period, as well as extended lymph dissection involving cardiopulmonary plexus located in the area of bifurcation. The latter factor is the peculiarity of surgery caused by oncological considerations, while three former factors should be taken into account during management of patients in the intra- and postoperative periods.

Cardia↗
PubMed1976

Effects of some drugs on electrical activity of the gut in the postoperative period.

Myoelectrical activity of the gut has been studied in the postoperative period on 54 patients who underwent cholecystectomy. They have been divided into one control group and four other groups which were treated with pentagastrin, cholecystokinin, prostigmine or coherin (a posterior pituitary extract). In all patients, bursts of spikes were recorded during the early postoperative period. However, the slow waves were strongly disturbed at this time. Pentagastrin, CCK-PZ and prostigmine had no effect on the slow waves, while they increased the frequency of the spikes. These substances did not reduce the duration of the 'physiological' ileus. On the contrary, coherin was found to improve the regularity of the slow waves and to reduce the duration of the 'physiological' ileus.

Cholecystectomy↗
PubMedDate not supplied

[The status of the receptor-controlled calcium metabolism of the thrombocytes in patients in the early postoperative period].

Basic changes in receptor-controlled platelet calcium metabolism that occur in the early postoperative period under the effect of aggregation-inducing hormones--platelet activation factor (PAF), adenosine phosphate (ADP) and vasopressin--are reviewed. Patients after lung surgery and patients with ischemic heart disease after aortocoronary bypass surgery have been examined. Patients operated on for malignant lung tumours developed increased postoperative sensitivity to ADP, while in patients after aortocoronary bypass surgery the early postoperative period was characterized by decreased sensitivity to PAF and vasopressin.

Adenosine Diphosphate↗