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Biomedical subjects

X Sala

Publications and source records attributed to X Sala.

At least 19 recordsLinked to original sources
PubMed2000

Airway ignition during CO2 laser laryngeal surgery and high frequency jet ventilation.

We present a case of a patient submitted for extirpation of a neoplasm of the larynx, by means of carbon dioxide laser surgery. High frequency jet ventilation was applied by means of orotracheal intubation with two Teflon catheters, 2 mm in external diameter and 30 cm in length, attached with three equally placed strips of adhesive paper tape. One catheter was used to inject the jet volume and the other used to measure the airway pressure. The adhesive strips were moistened and FiO2 was lower than 50%. After 30 min using the laser, an airway fire was noticed. Ventilation was interrupted and the catheters were removed. The patient was reintubated with an endotracheal tube of 6 mm ID and the surgical procedure was continued until the tumour was removed. Two factors contributed to the airway fire: the ignition of the lowest adhesive strip that had dried and the use of the laser in the mode of continuous pulsation.

Fires↗
PubMed1998

Postoperative respiratory function in children after abdominal surgery. A comparison of epidural and intramuscular morphine analgesia.

Thirty children undergoing urological and abdominal surgery were entered into a randomised trial comparing the effects of epidural and intramuscular morphine on postoperative respiratory function. The forced vital capacity and the forced expired volume in 1 s were measured before and 6 h after surgery and on each of the following seven days. Significant decreases (p < 0.01) in forced vital capacity and forced expired volume in 1 s were seen after surgery. After the first postoperative day, a gradual recovery in pulmonary function was observed but the measured parameters had not returned to their pre-operative control values by the end of the study. There were no statistically significant differences between the two groups during the study with respect to forced vital capacity and forced expired volume in 1 s. The quality of analgesia was better in the epidural morphine group than in the intramuscular morphine group. The incomplete recovery of pulmonary function suggests that pain is not the only cause of postoperative respiratory changes in these patients.

Abdomen↗
PubMed1997

Cystic pyeloureteritis: review of 34 cases. Radiologic aspects and differential diagnosis.

OBJECTIVES: To refine the clinical and radiologic description of an unusual benign disease, cystic pyeloureteritis (CPU), consisting of the appearance of suburothelial cysts that raise the mucosa layer of the urothelium. We also studied its relationship with various types of inflammation, including chronic infection, that may be the stimulus for the appearance of CPU. METHODS: We compiled 34 cases of CPU covering the period 1976 to 1994, analyzing the clinical manifestations, diagnostic procedures, differential diagnosis, and evolution. RESULTS: There are no specific symptoms associated with the presence of cysts. The average age of the patients was 59 years (range 30 to 77). Urinary tract infection was detected in 18 (53%). The pyeloureteritis was unilateral in 27 (79%) and bilateral in 7 (21%) of the patients. The location of the cysts was as follows: 1 pyelic (3%); 6 pyeloureteral (18%); and 27 (79%) ureteral. Resolution of the radiologic alterations depends on the resolution of the associated pathology: infections, lithiasis, and obstruction. CONCLUSIONS: We conclude that CPU is a benign pathology with indolent evolution and variable duration; it is not associated with sequelae. Diagnosis is made on the basis of radiologic findings, mainly intravenous urography; in view of the minor entity of the pathology, biopsy is not advisable if the radiologic findings are conclusive.

Adult↗
PubMed1997

Effects of anesthetic technique on the hemodynamic response to microlaryngeal surgery.

Our aim was to study the attenuation of the hemodynamic response to microlaryngeal surgery by beta-blocking agents used as support drugs to the anesthetic technique. The study was carried out in 30 patients randomly allocated to one of three groups. The control group received only anesthetic drugs. The second group received labetalol hydrochloride 0.3 mg/kg 3 minutes before induction and 0.15 mg/ kg 2 minutes prior to the start of suspension of the larynx. The third group received esmolol hydrochloride 500 micrograms/kg 3 minutes prior to induction and a continuous infusion of 300 micrograms/kg during the surgical procedure. Hemodynamic data in the three groups were compared by analysis of variance. A statistically significant difference (p < .05) was found in hemodynamic data among the two groups treated with blocking agents and the control group. The addition of beta-blocking agents to the anesthetic technique attenuates the hemodynamic response to suspension laryngoscopy.

Adrenergic alpha-Antagonists↗
PubMed1997

[Comparative study of high-frequency jet ventilation in 4 types of patients undergoing laryngeal microsurgery].

OBJECTIVE: To study high frequency jet ventilation (HFJV) in patients with chronic obstructive pulmonary disease (COPD) who are obese or who have tracheal or laryngeal stenosis, conditions which are often found in patients undergoing microsurgery of the larynx (MSL), comparing the results with those for a group of controls, patients with no stenosis who were also undergoing MSL. PATIENTS AND METHOD: Eighty patients were distributed in four groups as follows: those meeting the criteria for a diagnosis of COPD (n = 20), those who were overweight (n = 24), those with stenosis over 50% of the laryngeal opening (stenosis group, n = 10) and those with no associated pathology (control group, n = 26). HFJV was administered through a 2.2 mm internal diameter orotracheal injection catheter, using an Ergojet CVT (Temel, S.A.). The ventilatory protocol was as follows: rate 100 breaths/min, inspiratory time 30%, generator pressure (GP) 2.2 to 3.3 kg/cm2 and FiO2 70% to 90%. We analyzed the GP administered, jet volume (Vjet) delivered, maximum (PAWmax) and minimum (PAWmin) airway pressures, oxygen hemoglobin saturation (SpO2), partial pressures of O2 (pO2) and CO2 (pCO2) in arterial blood, and end-tidal pressure of CO2 (PETCO2) at baseline and 10 and 20 min after the start of HFJV. Because monitoring was invasive, the study was designed for a small series of patients and we believe it should not be generalized to include all patients undergoing MSL under normal conditions. RESULTS: HFJV had to be abandoned and conventional ventilation used in 4 patients (2 in the COPD group and 2 in the obese group). Ventilation was judged adequate in the remaining patients, with the observations that in the COPD group, pO2 levels were lower than in the control group at the 10 min readings and pCO2 levels were higher at both the 10 and 20 min readings. PAW levels were higher throughout the procedure in both the COPD and stenosis groups. In the obese patients, pCO2 was higher at both the 10 and 20 min recordings. CONCLUSION: HFJV provides effective ventilation for most patients undergoing MSL, even if they are obese or have COPD or laryngeal stenosis.

Adult↗
PubMed1994

Maternal primary pulmonary hypertension associated with pregnancy.

Primary pulmonary hypertension (PPH) is a very uncommon clinical entity, with a high mortality when associated with pregnancy. Three cases of PPH associated with gestation and different outcomes are reported, and a literature review concerning its management and outcome is made. We emphasize the importance of a strict control of such patients, with the supportive cardiovascular measures and surveillance of fetal well-being. The peculiar handling of the course of delivery and the type of anaesthesia is discussed.

Adolescent↗
PubMed1994

[Intermittent hydronephrosis].

Intermittent hydronephrosis is a frequent cause of obstruction in the ureteropelvic junction in the adult. Diagnosis is based on intravenous pyelography, echography and renal scintigraphy with or without hyperdiuresis. We report a case of intermittent hydronephrosis successively affecting both kidneys.

Adult↗