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Studies have demonstrated an imme- diate decline in urine output after the institution of mechanical ventilation. Hormonal pathways at the kidney level are also altered during mechanical ventilation. Increased plasma renin activity leading to reduced renal blood fl ow has been described [109] .Lastly, renal dysfunction during mechanical ventilation may be secondary to biotrauma associated with injurious ventila- tory strategies...
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85 Frutos - Vivar F , Esteban A , Apezteguia C et al. 86 Stewart TE , Meade MO , Cook DJ et al. 87 Kuiper JW , Groeneveld ABJ , Slutsky AS et al. 88 Cheng IW , Eisner MD , Thompson BT et al. 89 Caldwell - Kenkel JC , Currin RT , Coote A et al. 90...
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The femoral vein can be located 1 – 2 cm medial to the pal- pated femoral artery pulse. If the femoral artery cannot be pal- pated, the location of the femoral vein can be estimated by imagining a line from the anterior superior iliac crest to the pubic tubercle and then dividing the line into equal thirds. The femoral artery...
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5% glucose) are contraindicated because they may cause osmotic swelling and hemolysis of red cells as well as clumping of red cells in the tubing. lactated Ringer ’ s) may cause coagulation of blood stored in citrate preservatives. Preparatory to a transfusion of red blood cells, it is essential to determine if transfused cells will be destroyed in vivo by...
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34 Valeri CR , Dennis RC , Ragno G et al. Limitations of the hematocrit to assess the need for red blood cell transfusion in hypovolemic anemic patients . Am J Obstet Gynecol 1972 . Obstet Gynecol Surv 2005 . A reappraisal of the need for autologous blood donation in the obstetric patient . Am J Obstet Gynecol 1990 ....
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Options for dialysis include hemodialysis and peritoneal dialysis, with the latter consisting of continuous ambulatory peritoneal dialysis (CAPD), continuous cycling peritoneal dialysis (CCPD), and nocturnal intermittent peritoneal dialysis (NIPD).. The various forms of peritoneal dialysis have in common the removal of these same metabolites and excess fl uid, albeit by dif- fusion and convective fl ow across the peritoneal membrane.....
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As the CPB techniques are changed, the blood gases of the fetus are evaluated. Some research- ers believe that information gained from this model should translate to CPB techniques of the human parturient because placental function is still being evaluated, albeit from the other side [40]. By comparing the vasoactive effects of acetylcholine (endothe- lium dependent) and nitroprusside (endothelium independent),...
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Together with a fall in cardiac output in the pre - eclamptic group, these fi ndings suggest a compensatory increase in ventricular size to maintain cardiac output against an elevated systemic vascular resistance.. The latter study also showed changes in the peak fi lling veloci- ties of the left ventricle during diastole. In pre - eclamspsia further augmentation of the...
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Pulmonary Artery Catheterization. 12 Califf RM , Fulkerson WJ , Jr , Vidaillet H et al. A randomised, controlled trial of the pulmonary artery catheter in criti- callyill patients . 14 Bernard GR , Sopko G , Cerra F et al. Pulmonary artery catheterization and clinical outcomes: National Heart, Lung,and Blood Institute and Food and Drug Administration Workshop Report. 15...
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A number of physiologic changes that occur in the pregnant patient can complicate intubation. There is signifi cant capillary engorgement of the mucosa throughout the respiratory tract leading to swelling of the nasal and oral pharynx, larynx, and trachea, all of which can increase the challenge of intubating a patient involved in an acute spinal cord injury [8. The initiation...
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The development of better imaging techniques, particularly MRI/MRA, has considerably facilitated radiologic diagnosis in the patient suspected of the condition.. The cerebral venous system of the human brain is unique in that major veins are composed of dural folds called sinuses which lack muscular walls, valves or the ability to contract. Hence blood can pool and clots form in these...
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Obstet Gynecol 2003 . Am J Obstet Gynecol 1999 . 59 Angulo - Vazquez J et al. 60 Argueta Zuniga M et al. Obstet Gynecol 2005 . Am J Obstet Gynecol 2000 . 64 Belfort MA , Varner MW , Dizon - Townson DS et al. Am J Obstet Gynecol 2002 . Obstet Gynecol 2001 . Acta Obstet Gynecol Scand...
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Optimal management of a patient with any specifi c combination of lesions requires a thorough assessment of the anatomic and functional capacity of the heart, followed by an analysis of how the physiologic changes described previously will impact on the specifi c anatomic or physiologic limitations imposed by the intrinsic disease. Intrapartum management principles include laboring in the lateral position;....
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In a series of patients with severe mitral stenosis, Clark and colleagues found that a postpartum rise in wedge pressure of up to 16 mmHg could be expected in the immediate postpartum period (Figure 20.4 ) [42. If intensive monitoring of intrapartum cardiac patients cannot be carried out in the manner described here, such recommendations for elective cesarean delivery may...
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Early and long term outcome of the arterial switch operation for transposition of the great arteries:. 76 Clarkson PM , Wilson NJ , Neutze JM , et al. Outcome of pregnancy after the Mustard operation for transposition of the great arteries with intact ventricular septum . Pregnancy following surgical cor- rection for transposition of the great arteries . 78 Drenthen...
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To assess blood fl ow in the lower extremities, IPG uses changes in electrical resistance in response to changes in fl uid volume. With infl ation of a thigh cuff, blood is retained in the leg. In the absence of venous obstruction, sudden defl ation results in immediate outfl ow of blood and a concomitant sudden increase in electrical resistance.....
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A review of 172 patients by Turrentine et al.. Obstet Gynecol 1995. Obstet Gynecol 1996 . 2 Chang J , Elam - Evans LD , Berg CJ , et al. Venous thromboembolism during pregnancy . Obstet Gynecol 1999 . 8 Rochat RW , Koonin LM , Atrash HK , et al. Obstet Gynecol 1988 . 9 Franks AL , Atrash...
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dL in 28%, and in all cases developed within 8 hours of the onset of symptoms [20. Acute renal tubular and cortical necrosis may result from the products of the coagulation cascade in addition to renal ischemia due to hypovolemia.. However, not all signs may be present simultaneously. Vaginal bleeding may be concealed, leading to delays in seeking medical help...
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It is generally simpler than a total hys- terectomy – the cervix and vaginal angles can be diffi cult to iden- tify in women who have labored to full dilation. of perineal hematoma in this group was found to be 7% com- pared to 2.2 per 1000 in the general population . It is a partial defi ciency state of...
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These studies showed an increased risk of preterm birth, low birth weight, pregnancy - induced hypertension, pre- eclampsia, hemorrhage, perinatal mortality and congenital mal- formations in patients with asthma . These authors also found an increased risk of preterm labor, pregnancy - induced hyperten- sion, small for gestational age, abruption, chorioamniotis, and cesarean delivery in patients with asthma [36. Demissie...