Browsing by Author "Coetzee, A."
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- ItemDiabetes mellitus and COVID-19 : a review and management guidance for South Africa(Health & Medical Publishing Group, 2020-08) Coetzee, A.; Taljaard, J. J.; Hugo, S. S.; Conradie, M.; Conradie-Smit, M.; Dave, J. A.ENGLISH ABSTRACT: This article reviews the association between diabetes mellitus (DM) and COVID-19. We report on the convergence of infectious diseases such as coronavirus infections and non-communicable diseases including DM. The mechanisms for the interaction between COVID-19 and DM are explored, and suggestions for the management of DM in patients with COVID-19 in South Africa are offered.
- ItemEffect of 1% and 2% propofol on blood lipids during long-term sedation(Health & Medical Publishing Group, 2002) Coetzee, A.; Blaine, E. M.; Labadarios, D.; Schall, R.; Haus, M.Objectives. To compare the effects of 1% and 2% propofol on the maximum and average lipid levels, the relative frequency of hyperlipidaemia, the propofol dose required to achieve an equivalent degree of sedation, the pharmacodynamie effects at the required infusion rates, and the effect on respiratory function. Design. Open, randomised, parallel group, multicentre comparison study. Setting. Intensive care units (ICUs) at the Faculty of Medicine, University of Stellenbosch and at Vergelen Medicity, Somerset West. Subjects. Patients who were artificially ventilated for at least 72 hours in the ICUs and who required sedation or analgesia. Outcome measures. Continuous intravenous infusion of 1% or 2% propofol to provide an administration rate in the range of 1 - 4 mg/kg/h. The initial infusion rate was about 2 mg/kg/h, adjusted to achieve the appropriate level of sedation. Results and conclusions. Seventy-five patients were enrolled in the study, of which 72 were evaluable for safety analysis and 58 were evaluable for efficacy analysis. The total daily dose of propofol (ml/day) in the 2% propofol group was about 60% of that in the 1% propofol group, indicating that the lipid load in the 2% propofol group had only slightly more than half the lipid load in the 1% propofol group. Thirteen of 27 patients (48%) int 2% propofol group had abnormally high triglyceride levels compared with 19 of 31 patients (61%) in the 1% propofol group. Similarly, 1 of 22 patients (4%) in the 2% propofol group had lipaemia compared with 4 of 30 patients (13%) in the 1% propofol group. Abnormal cholesterollevels, alveolar-arterial oxygen tension gradient and daily percentage of time with desired sedation were comparable between the two groups. The observed incidence of raised plasma triglyceride concentrations, and of lipaemia, was lower in the 2% propofol group than in the 1% propofol group, although the differences were not statistically significant. The 2% formulation of propofol appears to be as effective and at least as safe as 1% propofol.
- ItemEffect of magnesium on myocardial ischaemia and reperfusion injury(Health & Medical Publishing Group, 1999) Malherbe, S.; Conradie, S.; Coetzee, A.This study examined the effect of intravenous magnesium on the reperfusion injury of the porcine myocardium. Animals received general anaesthesia and the left anterior descending coronary artery was occluded for 15 minutes. Thereafter, reperfusion was allowed for 60 minutes. Regional ventricular function was measured with microsonometers. Animals were randomly assigned to a control (N = 6) or a magnesium group (N = 6). The latter received 30 mg/kg magnesium immediately before the release of the occlusion on the left anterior descending (LAD) artery. Results indicate that magnesium administration is associated with fewer ventricular arrhythmias and a rapid recovery (within 5 minutes) of myocardium systolic function once reperfusion was initiated. In the control group myocardial stunning was prolonged and more reperfusion arrhythmias occurred. However, in the group that received magnesium there was more diastolic dysfunction during reperfusion.
- ItemFeochromositoom tydens swangerskap(Health & Medical Publishing Group, 1981) Coetzee, A.; Hartwig, N.; Erasmus, F. R.Phaeochromocytoma during pregnancy, although rare, presents serious risks to the mother and fetus. An operation was done on a pregnant 19-year-old patient with this condition. The pre-operative preparation and anaesthetic management are discussed.
- ItemFilling pressures of the heart during anaesthesia(Health & Medical Publishing Group, 1985) Coetzee, A.; Stewart, R. I.; Hattingh, P.The validity of extrapolating central venous pressure (CVP) to left ventricular (LV) filling pressure as gauged from the pulmonary artery wedge pressure (PAWP) was investigated in 9 subjects undergoing lung resection. Correlations existed between CVP and PAWP before, during and after surgery, and between changes in CVP and PAWP during surgery. There was, however, a wide scattering of the data around the regression lines, and an inability of the CVP and changes therein to predict the actual and directional change in PAWP in specific individuals. Caution is therefore advised in assessing the LV filling pressure from the CVP in patients undergoing lung resection during any phase of the peri-operative period.
- ItemIsgemiese hartsiekte as risiko vir algemene narkose en chirurgie(Health & Medical Publishing Group, 1984) Coetzee, A.; Van der Merwe, A.The risk of myocardial reinfarction in the patient who has suffered a pre-operative infarction is well documented. In a literature search, the cardiovascular risk implied by either asymptomatic or symptomatic ischaemic heart disease (without infarction) to the patient scheduled for anaesthesia and surgery appears to be minimal provided that hypotension, hypoxia, tachyarrhythmias and hypertension are avoided. However, a myocardial ischaemic incident prior to surgery seems to warrant the postponement of elective surgical procedures.
- ItemMagnesium and myocardial reperfusion injury : a study in patients undergoing coronary artery bypass surgery(Health & Medical Publishing Group, 1999) Govender, V.; Le Roux, P.; Roussouw, G.; Coetzee, A.This study examined the effect of various doses of magnesium sulphate on the reperfusion injury in patients subjected to coronary artery bypass surgery. Intravenous magnesium sulphate (0, 2, 4 and 6 g) was administered from the onset of surgery up to the release of the aortic cross-clamp. General haemodynamics, pharmacological support of the circulation, CK-MB fraction and Q-wave changes were monitored. In addition, the incidence and severity of reperfusion ventricular tachycardia or fibrillation were recorded. A total of 138 patients were successfully randomised into one of the groups. There was no difference in the demographics, general haemodynamics or arrhythmias between groups either before or after surgery. Results of this study do not support the use of magnesium (as per our protocol) as an effective method of limiting the reperfusion injury after cardiac surgery.
- ItemNitric oxide has little effect on acute pulmonary hypertension and right ventricular function during acute respiratory distress syndrome(Health & Medical Publishing Group, 1997) Luyt, S.; Coetzee, A.; Lahner, D.; Jansen, J.Objective. To evaluate the effect of nitric oxide (NO) on acute pulmonary hypertension and right ventricular function in patients with acute respiratory distress syndrome. Design. A prospective clinical study. Patients. Ten patients in the respiratory and surgical intensive care units were used. They met the criteria for acute respiratory distress syndrome and were significantly hypoxic. They were all ventilator-dependent at the time of the study. Intervention. NO was delivered to the patients in 5, 10, 20 and 30 ppm doses for 30 minutes at each concentration. The dosing was not randomised. Measurements and results. The general and central haemodynamics were measured. Right ventricular function and interaction with the pulmonary artery impedance (Ea) were quantified with the ratio of right ventricular stroke work index/Ea. NO did not decrease the raised pulmonary artery pressure found in all of the patients. Right ventricular coupling to the circulation did not improve during the administration of NO. Conclusion. NO did not relieve the acute pulmonary artery hypertension associated with acute respiratory distress syndrome. As a consequence of this, right ventricular function failed to improve during the administration of NO.
- ItemPeri-operative mortality in the anaesthetic service at Tygerberg Hospital(Health & Medical Publishing Group, 1992) Coetzee, A.; Du Toit, H.This study reports on the process of peer review of peri-operative mortality at Tygerberg Hospital. The peri-operative mortality rate for the past 3,5 years was 11,9/10000. The departmental evaluation committee thought that 3,4/10000 of these deaths were anaesthetic-related. In 2,3/10000, the anaesthetic contributed to the death of the patient and in 10 cases (total case load = 94945; i.e. 1,1/10000) anaesthesia was responsible for the death of the patient. The majority of the peri-operative deaths (8,5/10 000) were caused by a combination of trauma and haemorrhagic shock.
- ItemPreoperatiewe spesiale ondersoeke en intraoperatiewe arteriele suurstofspanning tydens eenlongnarkose(Health & Medical Publishing Group, 1990) Hattingh, P.; Coetzee, A.; McGregor, L.; Klopper, J. F.The value of preoperative lung function tests was examined in 11 patients as a method to predict changes in intraoperative PaO2 (dPaO2) during one-lung ventilation in pulmonary surgery. Ventilation (Kr-81m and Xe-133) and perfusion (Tc-99m microspheres) to the lung to be operated upon significantly predicted the intra-operative decrease in PaO2. The correlation between ventilation percentage to the diseased lung and dPaO2 was 0,87 (SEE = 9,99) and between perfusion and dPaO2 0,84 (SEE = 9,51).