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Filipescu, Daniela; Raileanu, I.; Luchian, M.; Andrei, Manuela-Anda; Tulbure, D

doi:10.1186/cc4547

Cited by 3 publications

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“…[5] Întreținerea, No 171 de altfel, se datorează într-o anumită ordine între membrii familiei. [6] Aceasta presupune că o persoană este îndreptățită să ceară întreținere de la un membru sau mai mulți membri ai familiei. Această ordine trebuie respectată, dacă persoana obligată la întreținere, în primul rînd, se găsește în imposibilitate de a acorda întreținere, atunci întreținerea se poate cere de la persoana obligată în ordinea imediat următoare, obligația deci fiind prin caracterul său -subsidiară.…”

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Condițiile legale privind nașterea obligației de întreținere între membrii familiei

Strelciuc

2023

InterConf+

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Condițiile legale privind nașterea obligației de întreținere între membrii familiei

Strelciuc

2023

InterConf+

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Study of Metabolic Acidosis in Patients Undergoing Surgeries of Operative Time Greater Than 2 Hours Duration

T.S¹,

Jeji²,

U³

2018

jebmh

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BACKGROUND Metabolic acidosis is proven complication of major surgery, but very less significance is given to it. Metabolic acidosis has a significant effect in postoperative recovery and morbidity of patients undergoing major surgery. Metabolic acidosis has a say in proper functioning of cardiovascular, renal and pulmonary system, added to severe stress full condition related to postoperative period, it bring about major shift in the speedy recovery of patient. It becomes significantly important that metabolic acidosis in diagnosed as early as possible and corrective measures are taken immediately. MATERIALS AND METHODS Study design is a prospective observational study. 109 patients who underwent elective and emergency surgeries in the department of General Surgery, Govt. Medical College Kottayam was studied for a period of 3 months (2016). On arrival of the patient, a detailed history of the patient was taken, along with emphasis to the multiple factors in the history which could be contributory to postoperative metabolic acidosis such as diabetic status, drug history, history of respiratory, cardiac and renal status. Basic preoperative laboratory investigation was carried out and its values were recorded. A preoperative arterial blood gas analysis (ABG) of the patient was done before patient was taken for surgery, values of which were recorded and analysed to rule out existing acidotic status of patient, if the patient is already having metabolic acidosis he was excluded from the study. A second ABG was sent at 2 hours after induction of anaesthesia, values of which was recorded, along with the values of intraoperative fluids, preoperative Hb, duration of surgery, type of surgery, blood transfusion and colloid administration given during the time of anaesthesia. A third ABG was sent within six hours of completion of surgery and the values analysed, with due notes on postoperative care done and the days of ICU stay, for analysis and comparison. RESULTS Duration of surgery was significantly related to incidence of both intraoperative and postoperative metabolic acidosis. When cross tabulation was done between operative duration and intra operative metabolic acidosis, it was found that 14(87.5%) subjects of total 16 who had duration of greater than 5 hrs had metabolic acidosis. 10 (62.5%) individuals of operative duration 2.01-3 hrs., 28 (73.7%) individuals from 3.01-4 hrs. group and 37 (94.9%) individuals from 4.01-5 hrs duration group were found to have intra operative metabolic acidosis. On doing an independent t test for calculating the significance of each of total crystalloid, normal saline and ringer lactate it was found that ringer lactate had a significant relationship with postoperative metabolic acidosis, indicated by a p value of 0.030, while normal saline had no significant relation to postoperative metabolic acidosis. Still it is interesting to note that total crystalloid administered had a significant relation to postoperative metabolic acidosis indicated by a p value of 0.047. Colloid administrati...

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Metabolic Acidosis in the Surgical Intensive Care Unit: Risk Factors, Clinical Correlates and Outcome. Findings from a High Dependency Heart and Vascular Surgical Center in Nigeria

Uduagbamen¹,

Sanusi²,

Udom³

et al. 2020

WJCS

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Background: Metabolic acidosis (MA) is a common finding on the surgical ward, more so in the intensive care unit. Diseases affecting the major organ systems of the body and higher grades of surgery are common risk factors for MA. It is associated with poor treatment outcome. Aim: To determine the risk factors and clinical correlates of metabolic acidosis and assess its relationship with treatment outcome. Methodology: A retrospective study at the "Tristate Heart and vascular Center" in Ilishan-Remo South west Nigeria, on patients that had cardiac and vascular surgeries from January 2015 to December 2019. Three hundred and forty two participants took part in the study. The demographic, clinical and laboratory findings were entered. Statistical analysis was with Student's t-test and Chi square. Results: Two hundred and six males and 136 females were studied. The incidences of metabolic acidosis prior to induction, on post-operative day one (POD 1) and on POD 28 were 20.7%, 39.8% and 14.1% respectively. Nine (2.6%) participants died during admission, of this, 6 (66.7%) had MA at presentation but all (100%) had MA on POD 1. The Risk factors for MA were advanced age, comorbidities, open heart surgery, elevated systolic blood pressure and low eGFR. Metabolic acidosis was a risk factor for prolonged hospital stay, perioperative death and declining kidney function which was commoner among participants with preexisting kidney dysfunction. Conclusion: The incidence of metabolic acidosis was 20.7% at induction of anesthesia, rose to 39.8% on POD 1 and by POD 28 , it has significantly reduced to 14.1%. While advancing age and com-How to cite this paper: Uduagbamen,

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Cited by 3 publications

References 1 publication

Condițiile legale privind nașterea obligației de întreținere între membrii familiei

Condițiile legale privind nașterea obligației de întreținere între membrii familiei

Study of Metabolic Acidosis in Patients Undergoing Surgeries of Operative Time Greater Than 2 Hours Duration

Metabolic Acidosis in the Surgical Intensive Care Unit: Risk Factors, Clinical Correlates and Outcome. Findings from a High Dependency Heart and Vascular Surgical Center in Nigeria

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