Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0020639 (hypoproteinemia)
 1,134 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We administered general anesthesia for an emergency abdominal surgery due to duodenal ulcer hemorrhage. The patient was in postoperative state after femoral supracondylar fracture, in pre-shock state, of old age (97 y-o), with severe anemia, and hypoproteinemia, and complicated with a giant abdominal aneurysm and mild aortic regurgitation. Before the operation, the patient was transferred to ICU and had intravascular volume replaced (infused with blood 600 ml, crystalloid fluid 2000 ml, colloid fluid 500 ml) and received stomach lavage. Under monitoring of direct arterial pressure, after fully pre-oxygenation, fentanyl 0.1mg was administered slowly, and crush induction was performed by a small dose of thiopental and SCC. After induction of anesthesia systolic blood pressure decreased to 60 mmHg temporarily and it was maintained between 80 and 120 mmHg during the surgery, but tachycardia continued (90-110.min-1). In order to treat oliguria owing to pre-shock state, we administered dopamine and urinastatin continuously. The patient was transferred to ICU postoperatively and close attention was paid. Postoperative pain controlled was well by epidural morphine and bupivacaine. The postoperative course was uneventful without any complications. Twenty three days later, abdominal aortic aneurysm resection was performed uneventfully. In this paper, problems of preanesthetic and anesthetic management of emergency abdominal surgery for an aged patient were discussed.
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PMID:[Anesthetic experience in emergency abdominal surgery in a 97-year-old patient complicated with a giant abdominal aneurysm]. 258 3

The effect of decreased colloid oncotic pressure, as seen in hypoalbuminemia and hypoproteinemia, upon intestinal function has been well delineated in the surgical literature. Patients undergoing abdominal aortic aneurysm resection or aortoiliac or aortofemoral bypass grafts are almost uniformly hypoalbuminemic postoperatively; with these two facts in mind, a prospective, randomized clinical study was undertaken to identify the role of serum albumin concentration on the length of postoperative ileus in this population. The main hypothesis was that patients whose albumin levels dropped below 3.5 gm/dL would have a more prolonged postoperative hospital course as a result of delay in return of bowel function when compared with those patients in whom the low albumin levels were exogenously acutely replenished to > 3.5 gm/dL. Albumin was replaced to a level greater-than or equal to 3.5 g/dL in one group of 37 patients (AR), with a control group of 32 patients (NR) not receiving any albumin. Return of bowel function was measured by the postoperative day that flatus was documented, as well as the postoperative day oral intake was resumed. Mean values were determined for each group, and t tests did not reveal a significant difference in postoperative day of flatus (AR mean = 4.06 days, NR mean = 4.16 days) or postoperative day of oral intake (AR mean = 4.0, NR mean = 3.75). Additional comparisons between the groups involving the number of postoperative days until a regular diet was begun (AR mean = 6.06, NR mean = 5.48) and length of postoperative hospital stay (AR mean = 9.16, NR mean = 8.43) failed to reveal significant differences.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Oncotic pressure, albumin and ileus: the effect of albumin replacement on postoperative ileus. 823