RESUMEN
Pulmonic stenosis is a frequent congenital heart disease in dogs, and the treatment of choice is balloon valvuloplasty which is usually safe and successful. The authors describe for the first time a severe complication after balloon valvuloplasty in a five-month-old dog. After effective treatment, with a considerable drop in right ventricular pressures, the dog developed hypoxemia and dyspnea due to pulmonary edema. The dog underwent intensive care and symptoms improved after a few hours of oxygen therapy, continuous positive airway pressure, and furosemide. Although this event is rare, it could have a large impact on patient survival and should be considered in the treatment of severe pulmonary valve stenosis in the future.
Asunto(s)
Valvuloplastia con Balón , Enfermedades de los Perros , Edema Pulmonar , Estenosis de la Válvula Pulmonar , Animales , Valvuloplastia con Balón/efectos adversos , Valvuloplastia con Balón/veterinaria , Enfermedades de los Perros/etiología , Enfermedades de los Perros/terapia , Perros , Edema Pulmonar/etiología , Edema Pulmonar/terapia , Edema Pulmonar/veterinaria , Estenosis de la Válvula Pulmonar/diagnóstico por imagen , Estenosis de la Válvula Pulmonar/etiología , Estenosis de la Válvula Pulmonar/terapia , Estenosis de la Válvula Pulmonar/veterinaria , Resultado del TratamientoRESUMEN
The introduction of a heat and moisture exchanger (HME) into the anaesthetic circuit may cause a rise in carbon dioxide (CO2) tension through an increase in dead space. We studied the effects of the Ultipor Pall BB50 filter included 'in series' in the Bain circuit on CO2 equilibrium. Arterial carbon dioxide tension (PaCO2) was measured in 81 patients scheduled for elective surgery before and after the insertion of the filter. Results showed that: females were always more hyperventilated than males when fresh gas flow was set at 70 ml kg-1 ideal body weight; the inclusion of the filter increased the PaCO2 in the group as a whole (the difference was statistically, but not clinically, significant); PaCO2 increased after the application of the filter only in females; the effects of the filter were completely independent of the patient's age. It is concluded that the use of the Ultipor Pall BB50 filter is a safe procedure during mechanical ventilation with the Bain breathing system and there is no need to modify ventilation.
Asunto(s)
Dióxido de Carbono/sangre , Filtración/instrumentación , Respiración Artificial/instrumentación , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Ensayos Clínicos como Asunto , Femenino , Calor , Humanos , Humedad , Masculino , Persona de Mediana Edad , Distribución Aleatoria , Seguridad , Factores SexualesRESUMEN
Stress is laid on the need for a multidisciplinary approach to the treatment of pain. Reference is made to personal experience, during which the presence of a psychiatric specialist in the team permitted the discovery of 4% of patients with pain of a purely psychological origin in a series of 300 subjects, together with 10% with pain of mixed origin. Attention is drawn to the usefulness of centering treatment on recognition and evaluation of the psychological component, and on treatment with antidepressive drugs in association with classic antalgic procedures.
