[Harelip and cleft palate, current status of therapy and problems of postoperative care].
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We present a modified version of the cervical collar that can be used immediately postoperatively and accommodates bulky bolster dressings. Its benefits include immediate neck hyperextension and immobilization and parallel monitoring of a skin graft or free flap.
Patients with cardiac disease have impaired ability to cope with stress. Considerable support may be needed in the postoperative period. Detailed manipulation of the circulation requires quantitative data whose acquisition is costly and potentially hazardous but it will optimize function and may have substantial benefit for the patient.
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The submitted paper should serve as a basis for recommended procedures of preoperative and postooperative care of diabetics. It contains the algorithm of preoperative preparation of diabetics focused on quantification of the risk of surgery. The diabetologist is the consultant of the surgeon who participates in the preparation of the patient for urgent as well as elective surgery. The procedures differ with regard to the type of diabetes. The authors mention in more detail the problem of preoperative care of operated diabetics and finally also monitoring and therapy of diabetics during the postoperative period.
PURPOSE OF REVIEW: The past two decades have seen tremendous technological advances in the care of infants and children with congenital and acquired heart disease. Recent advances in postoperative management have made it possible to support smaller and more fragile infants, extended the capabilities of extracorporeal circulation, and have brought new and innovative monitoring capabilities to the intensive care unit. RECENT FINDINGS: We chose to focus our review on four main themes: management of pulmonary hypertension, mechanical support of the myocardium, near infrared spectroscopy, and heparin-induced thrombocytopenia. SUMMARY: As operative and cardiopulmonary bypass techniques have evolved, early complete repair in neonates and repair of more complex lesions is now possible, creating new challenges for postoperative care in the intensive care unit. Additionally, recognition and management of newly appreciated complications is essential.
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