Trauma management during tragic years of Lebanon part III By Professor Anis Baraka

20. Post Pneumonectomy
Pulmonary Edema
1. Right Pneumonectomy.
2. Acute lung injury.
3. Fluid overload
4. Pulmonary hypertension complicated by
right ventricular failure.
5. Unbalanced post operative chest
drainage

26. Con: Continues Blood Monitoring Should Not Be A Standard During Cardiopulmonary
Bypass
Robert G.Merin
Finally, I find it somewhat peculiar that my worthy opponent, Dr Anis Baraka, should
be arguing in favor of this expensive high technology piece of equipment. All of us in
anesthesia and surgery who are acquainted with Dr Baraka marvel at his ability to
continue practicing high quality anesthesia through the ravages of the war in Beirut,
Lebanon. In addition, the fact that he has been able to continue to publish high-quality
scientific investigations in the face of an almost untenable situation is a tribute to his
talents and courage. However, it seems to me extremely unlikely that Dr Baraka's
hospital could consider the initial expense of this piece of equipment or the probable
maintenance costs. I would hope that the abusive medical and legal climates that exist
in the United States will not sp read to Europe and the Middle East.
CONTINUOUS BLOOD GAS MONITORING SHOULD BE A STANDARD
DURING CARDIOPULMONARY BYPASS
Pro: Continuous Venous Oximetry Should Be Used Routinely During
Cardiopulmonary Bypass
Anis Baraka, MBBCh, DA, DM, MD, FC Anesth
PRO AND CON
J,Earl Wyands, MD, Editor

49. TACHYPHYLAXIS TO CISATRACURIUM
- Case Reports and Literature Review -

53. Critical Illness Multiple
Neuropathy and/ or Myopathy

56. Bone et al. Chest 1992;101:1644
SIRSINFECTION
PANCREATITIS
BURNS
TRAUMA
OTHER
SEPSIS
SEVERE
SEPSIS
SEPTIC
SHOCK

57. SIRS
Widespread inflammatory response, >=2
Temperature > 38 C or < 36 C
Heart rate > 90 beats/ min
Respiratory rate of > 20 breaths/ min or PaCO2 < 32mmHg
WBC >12,000 , <4000 cells/ mm3 or >10% bands
SEPSIS
Systemic response to infection(SIRS + Infection)
SEVERE SEPSIS
Sepsis associated with organ dysfunction, hypoperfusion, or hypotension
SEPTIC SHOCK
Sepsis with hypotension and hypoperfusion despite adequate fluid resuscitation

58. Treatment