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Hypoxemia during anesthesia

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https://www.readbyqxmd.com/read/28621297/endoscopic-ultrasound-with-or-without-fine-needle-aspiration-has-a-meaningful-impact-on-clinical-care-in-the-pediatric-population
#1
Amit Raina, Maire A Conrad, Benjamin Sahn, Alireza Sedarat, Gregory G Ginsberg, Nuzhat A Ahmad, Vinay Chandrasekhara, Petar Mamula, Michael L Kochman
BACKGROUND AND OBJECTIVES: The safety and utility of endoscopic ultrasound (EUS) for the evaluation and management of gastrointestinal (GI) tract disorders among adults has been established. The literature on safety and efficacy in a pediatric referral population (under 21 years of age) is limited. We hypothesized that EUS is safe and useful in the pediatric population. We reviewed the pediatric EUS experience at a single tertiary-care system. We describe the indications, findings, safety, technical success rate, and impact on clinical outcomes...
May 2017: Endoscopic Ultrasound
https://www.readbyqxmd.com/read/28544250/prevalence-of-and-risk-factors-for-intraoperative-gastroesophageal-reflux-and-postanesthetic-vomiting-and-diarrhea-in-dogs-undergoing-general-anesthesia
#2
Carlos Torrente, Isabel Vigueras, Edgar G Manzanilla, Cecilia Villaverde, Laura Fresno, Bibiana Carvajal, Marina Fiñana, Cristina Costa-Farré
OBJECTIVE: To determine the prevalence of intraoperative gastroesophageal reflux (GER) and postanesthetic vomiting and diarrhea, and to evaluate risk factors associated with these gastrointestinal disorders (GID) in dogs undergoing general anesthesia. DESIGN: Prospective observational study. SETTING: University teaching hospital. ANIMALS: Two hundred thirty-seven client-owned dogs undergoing general inhalant anesthesia for diagnostic or surgical purposes...
May 23, 2017: Journal of Veterinary Emergency and Critical Care
https://www.readbyqxmd.com/read/28539301/-anesthesia-management-in-robotic-assisted-esophagectomy-with-triple-incisions-analysis-of-53-cases
#3
Xiao-Qing Liu, Tian-Hua Zhang, Jing Cheng, Hui-Ting Li, Long-Hui Cao, Zi-Hui Tan, Wen-Qian Lin
Between March, 2016 and January, 2017, 53 patients underwent robotic-assisted esophagectomy with triple incisions. All the patients were intubated with Double lumen endotracheal tub with one-lung ventilation and CO2 pneumoperitoneum, and CO2 pneumothorax was used in 7 cases. Most of the patients could tolerate OLV and CO2 pneumoperitoneum, and 4 patients with CO2 pneumothorax had hypoxemia and required double-lung ventilation or high frequency ventilation; 15 patients developed postoperative pulmonary complications and were transferred to ICU...
May 20, 2017: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
https://www.readbyqxmd.com/read/28538020/incidence-and-risk-factors-of-hypoxemia-during-interventional-rigid-bronchoscopy-under-spontaneous-assisted-ventilation
#4
Saowapark Chumpathong, Jamsak Tscheikuna, Thanatporn Boonsombat, Saipin Muangman, Choopong Luansritisakul
BACKGROUND: Interventional rigid bronchoscopy for tracheobronchial stenosis can be performed under total intravenous anesthesia and spontaneous-assisted ventilation. Intraoperative hypoxemia can occur during this procedure, but the incidence and risk factors have not yet been determined. MATERIALS AND METHODS: Medical records of patients who underwent rigid bronchoscopy for the treatment of tracheobronchial stenosis under total intravenous anesthesia and spontaneous-assisted ventilation during the study period from January 2011 to December 2012 were retrospectively reviewed...
May 19, 2017: Journal of Bronchology & Interventional Pulmonology
https://www.readbyqxmd.com/read/28416836/-comparison-between-flexible-laryngeal-mask-airway-and-reinforced-tracheal-tube-used-for-lumbar-vertebral-surgery-in-prone-position
#5
Y L Zheng, W F Song, D X Wang
OBJECTIVE: To estimate the safety and feasibility of flexible laryngeal mask airway (FLMA) for lumbar vertebral surgery in prone position. METHODS: In the study, 120 adult patients scheduled for lumbar vertebral surgery under intravenous general anesthesia were divided into group FLMA and reinforced tracheal tube (RTT) group at random. Heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP) were recorded at the beginning of anesthesia induction (T0) and on the time of artificial airway intubation (T1), 1 min after intubation (T2), extubation (T3), 1 min after extubation (T4) as well...
April 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28403091/effects-of-preoperative-chronic-hypoxemia-on-geriatrics-outcomes-after-hip-arthroplasty-a-hospital-based-retrospective-analysis-study
#6
Furong Zhang, Ruqiang Zhang, Liang He, Jianwei Yin, Fang Wang, Junmin Li
The partial pressure of oxygen decreases as altitude increases, the preoperative chronic hypoxemia (CH) may have a plausible clinical impact. Risk factors for postoperative serious adverse events (pSAEs) in patients living in high altitudes during primary hip arthroplasty (HA) are not clear.This is an observational study embracing patients from January 1, 2011 to December 31, 2015 at Yan'an Hospital of Kunming City, a 1338-bed municipal teaching hospital of Kunming Medical University. Univariate analysis revealed that significant differences between patients with and without preoperative CH occurred in intraoperative hypotension (77 [33%] vs 34 [47%], P = ...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28372678/randomized-trial-of-a-novel-double-lumen-nasopharyngeal-catheter-versus-traditional-nasal-cannula-during-total-intravenous-anesthesia-for-gastrointestinal-procedures
#7
Adam B King, Bret D Alvis, Douglas Hester, Susan Taylor, Michael Higgins
STUDY OBJECTIVE: Patients undergoing general anesthesia routinely experience episodes of hypoxemia. There are multiple causes of procedural oxygen desaturation including upper airway obstruction and central hypoventilation. We hypothesize that oxygen supplementation via nasopharyngeal catheter (NPC) will decrease the number of episodes of hypoxemia as compared to traditional NC oxygen supplementation in patients undergoing general anesthesia provided by an anesthesia provider for gastrointestinal endoscopy procedures...
May 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28348895/in-flight-hypoxemia-in-a-tracheostomy-dependent-infant
#8
Jason Quevreaux, Christopher Cropsey
Millions of passengers board commercial flights every year. Healthcare providers are often called upon to treat other passengers during in-flight emergencies. The case presented involves an anesthesia resident treating a tracheostomy-dependent infant who developed hypoxemia on a domestic flight. The patient had an underlying congenital muscular disorder and was mechanically ventilated while at altitude. Although pressurized, cabin barometric pressure while at altitude is less than at sea level. Due to this environment patients with underlying pulmonary or cardiac pathology might not be able to tolerate commercial flight...
2017: Case Reports in Anesthesiology
https://www.readbyqxmd.com/read/28334593/pediatric-postoperative-pulse-oximetry-monitoring-during-transport-to-the-postanesthesia-care-unit-reduces-frequency-of-hypoxemia
#9
Thomas J Caruso, Tara E Mokhtari, Monica J Coughlan, Diane S Wu, Juan L Marquez, Melissa Duan, Heather Freeman, Andrew Giustini, Mary Tweedy, Paul J Sharek
BACKGROUND: The standard use of pulse oximetry during the transport of postoperative patients from the operating room (OR) to the postanesthesia care unit (PACU) is not routinely practiced. A study was conducted to determine if the frequency of hypoxemia on admission to the PACU decreased after implementation of routine use of transport pulse oximeters for postoperative patients being transferred to the PACU. METHODS: In this prospective cohort study, which was conducted at an academic pediatric hospital, the primary outcome measure was the frequency of hypoxemic events on arrival to the PACU...
March 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28328974/retinal-oximetry-measures-systemic-hypoxia-in-central-nervous-system-vessels-in-chronic-obstructive-pulmonary-disease
#10
Thorunn Scheving Eliasdottir, David Bragason, Sveinn Hakon Hardarson, Charles Vacchiano, Thorarinn Gislason, Jona Valgerdur Kristjansdottir, Gudrun Kristjansdottir, Einar Stefánsson
BACKGROUND: Determination of the blood oxyhemoglobin saturation in the retinal vessels of the eye can be achieved through spectrophotometric retinal oximetry which provides access to the state of oxyhemoglobin saturation in the central nervous system circulation. The purpose of this study was to test the capability of the Oxymap T1 oximeter to detect systemic hypoxemia and the effect of supplemental oxygen on retinal vessel oxyhemoglobin saturation. METHODS: Oxygen saturation of hemoglobin in retinal arterioles and venules was measured in 11 subjects with severe chronic obstructive pulmonary disease (COPD) on long term oxygen therapy...
2017: PloS One
https://www.readbyqxmd.com/read/28326553/hypoxemia-after-single-shot-anesthesia-in-common-marmosets
#11
Naho Konoike, Miki Miwa, Akiyo Ishigami, Katsuki Nakamura
BACKGROUND: It remains unknown how single-shot anesthesia influences physical parameters, especially respiratory function and blood oxygen level of common marmosets (Callithrix jacchus) which came to be used for laboratory research. METHODS: We measured blood oxygen levels, both before and after oxygenation, in 13 common marmosets under two single-shot anesthesia conditions: ketamine/xylazine/atropine and alphaxalone. RESULTS AND CONCLUSIONS: We found that SpO2 values decreased to about 80% in the ketamine/xylazine/atropine protocol and fell just below 90% in the alphaxalone protocol...
June 2017: Journal of Medical Primatology
https://www.readbyqxmd.com/read/28315041/positive-pressure-ventilation-in-a-patient-with-a-right-upper-lobar-bronchocutaneous-fistula-right-upper-bronchus-occlusion-using-the-cuff-of-a-left-sided-double-lumen-endobronchial-tube
#12
Chieko Omori, Hiroaki Toyama, Yusuke Takei, Yutaka Ejima, Masanori Yamauchi
In patients with a bronchocutaneous fistula, positive pressure ventilation leads to air leakage and potential hypoxemia. A male patient with a right upper bronchocutaneous fistula was scheduled for esophageal reconstruction. His preoperative chest computed tomography image revealed aeration in the right middle and lower lobe, a large bulla in the left upper lobe, and pleural effusion and pneumonia in the left lower lobe. Therefore, left one-lung ventilation was considered to result in hypoxemia. Before anesthesia induction, the bronchocutaneous fistula was covered with gauze and film to prevent air leakage...
March 17, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28296782/the-safety-and-efficacy-of-dexmedetomidine-remifentanil-in-children-undergoing-flexible-bronchoscopy-a-retrospective-dose-finding-trial
#13
Xia Li, Xue Wang, Shuguang Jin, Dongsheng Zhang, Yanuo Li
Flexible bronchoscopy is more and more used for diagnosis and management of various pulmonary diseases in pediatrics. As poor coordination of children, the procedure is usually performed under general anesthesia with spontaneous or controlled ventilation to increase children and bronchoscopists' safety and comfort. Previous studies have reported that dexmedetomidine (DEX) could be safely and effectively used for flexible bronchoscopy in both adulate and children. However, there is no trial to evaluate the dose-finding of safety and efficacy of dexmedetomidine-remifentanil (DEX-RF) in children undergoing flexible bronchoscopy...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28260430/anesthetic-and-perioperative-management-of-nontransplant-surgery-in-patients-after-liver-transplant
#14
Zeynep Ersoy, Asude Ayhan, Aycan Ozdemirkan, Gulsi Gulsah Polat, Pinar Zeyneloglu, Gulnaz Arslan, Mehmet Haberal
OBJECTIVES: We aimed to document the anesthetic management and metabolic, hemodynamic, and clinical outcomes of liver-graft recipients who subsequently undergo nontransplant surgical procedures. MATERIALS AND METHODS: We retrospectively analyzed the data of 96 liver-graft recipients who underwent 144 nontransplant surgeries between October 1998 and April 2016 at Başkent University Hospital. RESULTS: The median patient age at the time of nontransplant surgery was 32 years, and 35% were female (n = 33)...
February 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28177565/the-impact-of-capnography-monitoring-among-children-and-adolescents-in-the-postanesthesia-care-unit-a-randomized-controlled-trial
#15
Melissa L Langhan, Fang-Yong Li, J Lance Lichtor
BACKGROUND: Pulse oximetry does not reliably recognize respiratory depression, particularly in the presence of supplemental oxygen. Capnography frequently detects hypoventilation and apnea among children recovering from anesthesia. Although children are routinely monitored with capnography during anesthesia, reducing the rate of adverse events, it is not routinely used in the postanesthesia care unit (PACU), where patients remain at risk for respiratory depression. AIM: We hypothesized that children monitored with capnography would have more frequent staff interventions and fewer adverse events than children monitored with pulse oximetry alone...
April 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28118413/a-double-blinded-randomized-comparison-of-medetomidine-tiletamine-zolazepam-and-dexmedetomidine-tiletamine-zolazepam-anesthesia-in-free-ranging-brown-bears-ursus-arctos
#16
Núria Fandos Esteruelas, Marc Cattet, Andreas Zedrosser, Gordon B Stenhouse, Susanne Küker, Alina L Evans, Jon M Arnemo
We compared anesthetic features, blood parameters, and physiological responses to either medetomidine-tiletamine-zolazepam or dexmedetomidine-tiletamine-zolazepam using a double-blinded, randomized experimental design during 40 anesthetic events of free-ranging brown bears (Ursus arctos) either captured by helicopter in Sweden or by culvert trap in Canada. Induction was smooth and predictable with both anesthetic protocols. Induction time, the need for supplemental drugs to sustain anesthesia, and capture-related stress were analyzed using generalized linear models, but anesthetic protocol did not differentially affect these variables...
2017: PloS One
https://www.readbyqxmd.com/read/28099321/preoxygenation-physiologic-basis-benefits-and-potential-risks
#17
Usharani Nimmagadda, M Ramez Salem, George J Crystal
Preoxygenation before anesthetic induction and tracheal intubation is a widely accepted maneuver, designed to increase the body oxygen stores and thereby delay the onset of arterial hemoglobin desaturation during apnea. Because difficulties with ventilation and intubation are unpredictable, the need for preoxygenation is desirable in all patients. During emergence from anesthesia, residual effects of anesthetics and inadequate reversal of neuromuscular blockade can lead to hypoventilation, hypoxemia, and loss of airway patency...
February 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28074800/effectiveness-of-ventilation-of-nondependent-lung-for-a-brief-period-in-improving-arterial-oxygenation-during-one-lung-ventilation-a-prospective-study
#18
Keerthi Chigurupati, Suneel Puthuvassery Raman, Unnikrishnan Koraparambil Pappu, Unnikrishnan Madathipat
BACKGROUND: Hypoxemia is common during one-lung ventilation(OLV), predominantly due to transpulmonary shunt. None of the strategies tried showed consistent results. We evaluated the effectiveness of ventilating the operated, non-dependent lung (NDL) with small tidal volumes in improving the oxygenation during OLV. METHODS: 30 ASA 1 and 2 patients undergoing elective, open thoracotomy were studied. After standard induction of anesthesia, lung seperation was acheived with left sided DLT...
January 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28072737/the-efficacy-of-dexmedetomidine-remifentanil-versus-dexmedetomidine-propofol-in-children-undergoing-flexible-bronchoscopy-a-retrospective-trial
#19
Hongquan Zhang, Baojun Fang, Wenjing Zhou
Flexible bronchoscopy has been more and more used for diagnosis and management diseases of respiratory system in pediatrics. Previous studies have reported that remifentanil (RF) and propofol are safe and effective for flexible bronchoscopy in adults, however, there have no trials evaluate the efficacy of DEX-RF versus dexmedetomidine-propofol in children undergoing flexible bronchoscopy.We divided 123 children undergoing flexible bronchoscopy with DEX-RF or dexmedetomidine-propofol into 2 groups: Group DR (n = 63, DEX infusion at 1...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27910802/near-infrared-spectroscopy-evaluated-cerebral-oxygenation-during-anesthesia
#20
REVIEW
Henrik Sørensen
Likely, maintained organ and notably cerebral perfusion, secures rapid recovery following anesthesia. To secure cerebral blood flow (CBF) at least mean arterial pressure (MAP) and the arterial carbon dioxide tension (PaCO2) need to be considered. CBF is "autoregulated", i.e. stays more or less stable within a MAP of 50-150 mmHg, but the lower limit appears to depend on the central blood volume and/or cardiac output, illustrated by a decrease in CBF at a MAP of 80 mmHg with a compromised central blood volume, while CBF remains constant with a MAP < 40 mmHg, if the central blood volume is maintained...
December 2016: Danish Medical Journal
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