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Haemodynamically Stable Patients (haemodynamically + stable_patient)
Selected AbstractsMulti-detector CT angiography for lower gastrointestinal bleeding: Can it select patients for endovascular intervention?JOURNAL OF MEDICAL IMAGING AND RADIATION ONCOLOGY, Issue 1 2010PT Foley§ Summary This is a retrospective review of the results at our institution of using multi-detector CT angiography (CTA) to localise lower gastrointestinal (GI) bleeding. We hypothesised that in our patient population: (i) CTA was unlikely to demonstrate bleeding in patients who were haemodynamically stable; (ii) in haemodynamically unstable patients in whom CTA was undertaken, the results could be used to select patients who would benefit from catheter angiography; and (iii) in haemodynamically unstable patients in whom CTA was undertaken, a subgroup of patients could be identified who would benefit from primary surgical treatment, avoiding invasive angiography completely. A retrospective review was conducted of the clinical records of all patients undergoing CTA for lower GI haemorrhage at our institution between 1 January 2005 and 30 June 2007. Out of the 20 patients examined, 10 had positive CTAs demonstrating the bleeding site. Nine were haemodynamically unstable at the time of the study. Four patients with positive CT angiograms were able to be treated directly with surgery and avoided invasive angiography. Ten patients had negative CTAs. Four of these were haemodynamically unstable, six haemodynamically stable. Only one required intervention to secure haemostasis, the rest stopped spontaneously. No haemodynamically stable patient who had a negative CTA required intervention. CTA is a useful non-invasive technique for localising the site of lower GI bleeding. In our patient population, in the absence of haemodynamic instability, the diagnostic yield of CTA was low and bleeding was likely to stop spontaneously. In haemodynamically unstable patients, a positive CTA allowed patients to be triaged to surgery or angiography, whereas there was a strong association between a negative CTA and spontaneous cessation of bleeding. [source] Repeatability of measurements of the initial distribution volume of glucose in haemodynamically stable patientsJOURNAL OF CLINICAL PHARMACY & THERAPEUTICS, Issue 4 2004B. O. Rose MD Summary Aims:, The initial distribution volume of glucose (IDVG) has been proposed to provide a useful tool to estimate the central extracellular fluid volume. The purpose of this study was to determine the repetition interval of two consecutive measurements in haemodynamically stable patients without presence of recent changes in fluid status. Methods:, Twenty-nine patients admitted to the general intensive care unit of the University of Hirosaki Hospital were entered into this study. After achieving a haemodynamically stable state in each patient regardless of an infusion of vasoactive drugs, two glucose challenges at an interval of either 30 or 60 min, were carried out to calculate the IDVG. The IDVG was calculated using a one-compartment model after intravenous administration of glucose (5 g) followed by serial arterial blood sampling. Results:, Although plasma glucose levels immediately before the second glucose challenge in either group were increased compared with those of the first challenge (P < 0·001, respectively), the bias of the IDVG measurements was 0·08 ± 0·32 L (SD) for the 30-min group and ,0·19 ± 0·28 L for the 60-min group. Conclusions:, Our results indicate that IDVG determinations can be reliably repeated within a minimum interval of 30 min. [source] Guidelines for the management of haemodynamically stable patients with stab wounds to the anterior abdomenANZ JOURNAL OF SURGERY, Issue 1-2 2008Priv Doz (Vienna), Thomas Nau MD No abstract is available for this article. [source] Guidelines for the management of haemodynamically stable patients with stab wounds to the anterior abdomenANZ JOURNAL OF SURGERY, Issue 1-2 2008BMedSc, PGDipSurgAnat, Warren M. Rozen MB BS No abstract is available for this article. [source] Treatment of ruptured hepatocellular adenomaBRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 2 2001T. Terkivatan Background: As the morbidity and mortality rates associated with emergency resection in patients with a ruptured hepatocellular adenoma are high, the authors have favoured initial non-operative management in haemodynamically stable patients. Methods: A retrospective study was performed to evaluate the treatment of ruptured hepatocellular adenoma. Results: Over a 21-year interval, 12 patients presented with a ruptured hepatocellular adenoma. Haemodynamic observation and support was the initial management in all 12 patients. Three underwent urgent laparotomy and gauze packing because of haemodynamic instability; no emergency liver resection was necessary. Eight patients had definitive surgery; three developed postoperative complications but none died. Regression of the tumour was observed in three of four patients treated conservatively. Conclusion: The initial management of a ruptured hepatocellular adenoma should be haemodynamic stabilization. Definitive resection is required for rebleeding or for tumours exceeding 5 cm in diameter. A conservative approach may well be justified in case of regression of an asymptomatic adenoma. © 2001 British Journal of Surgery Society Ltd [source] | ||||||||||