Asunto(s)
Perforación del Esófago/diagnóstico , Enfermedades del Mediastino/diagnóstico , Neumotórax/diagnóstico , Radiografía Torácica , Tomografía Computarizada por Rayos X , Biomarcadores/análisis , Perforación del Esófago/patología , Humanos , Masculino , Enfermedades del Mediastino/patología , Persona de Mediana Edad , Neumotórax/etiologíaRESUMEN
An important iatrogenic cause of anaemia in the intensive care unit is loss of the discarded blood during phlebotomy via indwelling vascular catheters. A closed system blood conservation device has previously been shown to reduce the need for blood transfusion and to blunt the decrease of haemoglobin in intensive care unit patients. However such a device may not benefit patients who are admitted with a relatively preserved haemoglobin. In this sub-group analysis of a before-and-after study, 128 patients had admission haemoglobin > or =115 g/l and did not receive any blood transfusions while in the intensive care unit. In the control group of 50 patients a blood conservation device was not used, while in the active group of 78 patients the device was used. Use of the blood conservation device did not affect the haemoglobin trends when both groups were compared using the general linear model. For patients with admission haemoglobin > or = 115 g/l, use of a blood conservation device does not affect the subsequent rate of haemoglobin decline in the intensive care unit. These patients are unlikely to benefit from the use of such devices.
Asunto(s)
Recolección de Muestras de Sangre/instrumentación , Transfusión Sanguínea , Hemoglobinas/análisis , Unidades de Cuidados Intensivos , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , FlebotomíaRESUMEN
We conducted a randomised controlled study to evaluate whether watching video compact discs intra-operatively using a liquid crystal display (LCD) unit decreased anxiety. Forty-four patients undergoing elective surgery under regional anaesthesia were assigned to either the LCD or control group. Anxiety was measured using the Chinese version of the State-Trait Anxiety Inventory (STAI) and visual analogue score (VAS). The mean (SD) anxiety trait scores were 46.15 (6.28) and 46.40 (7.32) in the control and LCD groups, respectively. The state anxiety of the LCD group [35.50 (7.96)] measured immediately postoperatively was significantly lower than the control group [41.50 (9.02); p = 0.03]. The median (range) reduction in VAS anxiety score was not significantly greater in the LCD group [20 (20 to 80) mm] compared with the control group [12.5 (70 to 60) mm]. Watching video intra-operatively reduces patient anxiety as measured by the STAI.
Asunto(s)
Anestesia de Conducción , Ansiedad/prevención & control , Cuidados Intraoperatorios/métodos , Complicaciones Intraoperatorias/prevención & control , Grabación de Videodisco , Adolescente , Adulto , Anciano , Ansiedad/etiología , Procedimientos Quirúrgicos Electivos/psicología , Femenino , Humanos , Complicaciones Intraoperatorias/psicología , Masculino , Persona de Mediana Edad , Satisfacción del Paciente , Escalas de Valoración Psiquiátrica , Factores de RiesgoRESUMEN
This prospective study assessed the outcome of percutaneous cannulated screw fixation in 49 of 60 acute scaphoid fractures. The union rate was 100% (mean time for radiological union at 12 weeks). There were no early or mid-term complications and all achieved an excellent functional recovery.