Browsing by Author "Coetzee, A. R."
Now showing 1 - 5 of 5
Results Per Page
Sort Options
- ItemCommunity-acquired pneumonia - factors influencing intensive care admission(Health & Medical Publishing Group, 1988-01) Van Eeden, S. F.; Coetzee, A. R.; Joubert, J. R.The mortality rate in critically ill patients with pneumonia who receive invasive vital organ support, including mechanical ventilation, in an intensive care unit (ICU) remains above 50%. The contribution of these costly life support systems to the survival of patients with extensive pneumonia is a matter for debate. The high mortality rate in this group of patients can be attributed in part to the fact that they are frequently referred for ICU care when their condition has already deteriorated to the point of no return. A retrospective study over 18 months of 34 cases of community-acquired pneumonia (17 patients required ventilatory support in the respiratory ICU) was undertaken to identify criteria which would justify early admission to an ICU. These were first-line clinical and biochemical factors, three of which were present in all patients on admission to hospital: (i) bronchopneumonia or lobar pneumonia involving more than two lobes (P < 0.001); (ii) respiratory rate > 30/min (P < 0.001); and (iii) partial arterial oxygen pressure < 8 kPa (P < 0.001). Other systemic factors associated with a poor prognosis and admission to the ICU were clinical signs of septicaemia, abnormal liver function and low serum albumin value. A scoring system for severity of pneumonia based on these factors is proposed. The possibility of an improved prognosis in a potentially reversible disease can become a reality if this approach is employed prospectively.
- ItemThe effect of acute haemodilution during cardiopulmonary bypass on blood calcium, pH, phosphorus and protein values(Health & Medical Publishing Group, 1983) Coetzee, A. R.; Van der Merwe, W. L.; Taljaard, J. J. F.; Els, D.The changes in total serum calcium, ionized calcium, total serum proteins, albumin and phosphate levels during cardiopulmonary bypass were measured. The possible causes of the changes in these parameters are discussed. The effect of the presence of heparin on serum ionized calcium is evaluated. The metabolic and clinical significance of the changes in blood components measured are discussed, special attention being paid to the use of calcium as an inotropic agent at the termination of cardiopulmonary bypass.
- ItemOral midazolam in paediatric premedication(Health & Medical Publishing Group, 1991) Payne, K. A.; Coetzee, A. R.; Mattheyse, F. J.; Dawes, T.In a premedication study involving 135 children, aged 1-10 years, four regimens were investigated: (i) no premedication; (ii) oral trimeprazine tartrate 2 mg/kg, methadone 0.1 mg/kg, droperidol 0.15 mg/kg (TMD); (iii) intramuscular midazolam (Dormicum; Roche) 0.15 mg/kg; and (iv) oral midazolam 0.45 mg/kg. All premedications were given 60 minutes before a standard halothane anaesthetic. No impairment of cardiovascular stability occurred but after premedication the mean oxygen saturation decreased by 1.6% and 1.1%, respectively, in the intramuscular midazolam and TMD groups. Overall, children under 5 years of age behaved less satisfactorily in the holding room and at induction, than those over 5 years (P<0.01). Midazolam, intramuscularly and orally, produced more satisfactory behaviour than the other two regimens (P<0.05) and, combined with a 70% more rapid recovery than the TMD regimen (P<0.05), suggests that oral midazolam is a more effective paediatric premedication agent than placebo or TMD.
- ItemPancreatic transplantation in a patient with severe insulin resistance : a case report(Health & Medical Publishing Group, 1988) Du Toit, D. F.; Heydenrych, J. J.; Coetzee, A. R.; Weight, M.A 22-year-old white woman with insulin-dependent diabetes mellitus of 20 years' duration and advanced secondary complications underwent pancreatic transplantation for severe insulin resistance and rapidly progressive nephropathy. Resistance to all forms and strengths of subcutaneously administered insulin had necessitated almost permanent hospitalisation for the previous 10 years. Short-term improvement of the endocrine and metabolic status was achieved by initial segmental and subsequent whole pancreatic transplantation.
- ItemRural anaesthetic practices in the Western Cape(Health & Medical Publishing Group, 1991) Payne, K. A.; Muller, C. J. B.; Coetzee, A. R.The findings of specialist anaesthetists on visits to rural towns in the western Cape over 6 years are reported. The importance of academic units communicating with general practitioners, nursing staff and hospital authorities in their own working environment is emphasised. Hospital anaesthetic facilities and general practice anaesthetic methods are discussed and recommendations made and, in addition, common problems that could improve anaesthesia in general practice are summarised.