keyword
https://read.qxmd.com/read/33439605/covid-19-anesthesia-machine-circuit-pressure-during-use-as-an-improvised-icu-ventilator
#21
JOURNAL ARTICLE
Vinh Pham, Le Nguyen, Riley J Hedin, Courtney Shaver, Kendall A P Hammonds, William C Culp
BACKGROUND: Use of anesthesia machines as improvised ICU ventilators may occur in locations where waste anesthesia gas suction(WAGS) is unavailable. Anecdotal reports suggest as much as 18 cmH2O positive end-expiratory pressure(PEEP) being inadvertently applied under these circumstances, accompanied by inaccurate pressure readings by the anesthesia machine. We hypothesized that resistance within closed anesthetic gas scavenging systems(AGSS) disconnected from WAGS may inadvertently increase circuit pressures...
January 12, 2021: Anesthesia and Analgesia
https://read.qxmd.com/read/33431268/quantification-of-reservoir-bags-as-airway-pressure-limiting-devices-in-a-nonrebreathing-system
#22
JOURNAL ARTICLE
Tamas D Ambrisko, Arnon Gal, Jesus N Sarol, Ashley Mitek, Christina Braun
OBJECTIVE: To evaluate the influence of reservoir bag types, volumes and previous use on the peak pressures (Pmax) and the times to develop 30 cmH2 O pressure (P30) within a nonrebreathing system with a closed adjustable pressure-limiting (APL) valve. STUDY DESIGN: In vitro study using three-way factorial design with repeated measure on one factor. SUBJECTS: A total of 75 new anesthesia reservoir bags (five types, three volumes, five bags from each type × volume)...
March 2021: Veterinary Anaesthesia and Analgesia
https://read.qxmd.com/read/32947290/carbon-dioxide-absorption-during-inhalation-anesthesia-a-modern-practice
#23
REVIEW
Jeffrey M Feldman, Jan Hendrickx, R Ross Kennedy
CO2 absorbents were introduced into anesthesia practice in 1924 and are essential when using a circle system to minimize waste by reducing fresh gas flow to allow exhaled anesthetic agents to be rebreathed. For many years, absorbent formulations consisted of calcium hydroxide combined with strong bases like sodium and potassium hydroxide. When Sevoflurane and Desflurane were introduced, the potential for toxicity (compound A and CO, respectively) due to the interaction of these agents with absorbents became apparent...
April 1, 2021: Anesthesia and Analgesia
https://read.qxmd.com/read/32898683/ultra-high-field-10-5-t-resting-state-fmri-in-the-macaque
#24
JOURNAL ARTICLE
Essa Yacoub, Mark D Grier, Edward J Auerbach, Russell L Lagore, Noam Harel, Gregor Adriany, Anna Zilverstand, Benjamin Y Hayden, Sarah R Heilbronner, Kamil Ugurbil, Jan Zimmermann
Resting state functional connectivity refers to the temporal correlations between spontaneous hemodynamic signals obtained using functional magnetic resonance imaging. This technique has demonstrated that the structure and dynamics of identifiable networks are altered in psychiatric and neurological disease states. Thus, resting state network organizations can be used as a diagnostic, or prognostic recovery indicator. However, much about the physiological basis of this technique is unknown. Thus, providing a translational bridge to an optimal animal model, the macaque, in which invasive circuit manipulations are possible, is of utmost importance...
September 5, 2020: NeuroImage
https://read.qxmd.com/read/32786105/the-implementation-of-low-flow-anesthesia-at-a-tertiary-pediatric-center-a-quality-improvement-initiative
#25
JOURNAL ARTICLE
Todd A Glenski, Laura Levine
INTRODUCTION: Anesthesia machines have evolved over the years to excel in delivering low-flow anesthesia (<1 L fresh gas flow) in a closed-circuit system, with the obvious benefits being decreased costs and reduced emissions of greenhouse gases. At a pediatric hospital that provides over 25 000 anesthetics a year, a quality improvement project was initiated with the aim of decreasing the amount of sevoflurane used per anesthetic by 20% over the course of a year. METHODS: Three Plan-Do-Study-Act cycles involving gathering comparative data, departmental education, improvement updates on our huddle board, and intraoperative confirmation rounds were completed...
October 2020: Paediatric Anaesthesia
https://read.qxmd.com/read/32705442/unexpected-deposits-in-the-anesthetic-circuit-a-possible-cause-of-peep-pmax-valve-malfunction
#26
JOURNAL ARTICLE
Takamitsu Ikeda, Ryo Orii, Masaki Iwakiri, Kanji Uchida, Yoshitsugu Yamada
PEEP is regulated by the internal PEEP/maximum peak inspiratory pressure limit (Pmax) valve. Malfunctioning of the PEEP/Pmax valve can result in the creation of unintentional or unstable PEEP, and a reduction of inspired tidal volume. Some of our Dräger Fabius® anesthesia machines were noted to exhibit changes in expiratory waveforms and unstable PEEP during general anesthesia. We considered that the cause was associated with PEEP/Pmax valve malfunction, and then investigated the problems in collaboration with the manufacturer...
July 23, 2020: Journal of Clinical Monitoring and Computing
https://read.qxmd.com/read/32601242/cortical-corticospinal-and-reticulospinal-contributions-to-strength-training
#27
JOURNAL ARTICLE
Isabel S Glover, Stuart N Baker
Following a program of resistance training, there are neural and muscular contributions to the gain in strength. Here, we measured changes in important central motor pathways during strength training in two female macaque monkeys. Animals were trained to pull a handle with one arm; weights could be added to increase load. On each day, motor evoked potentials in upper limb muscles were first measured after stimulation of the primary motor cortex (M1), corticospinal tract (CST) and reticulospinal tract (RST)...
June 29, 2020: Journal of Neuroscience
https://read.qxmd.com/read/32442094/sevoflurane-consumption-during-inhalational-induction-in-children-a-randomized-comparison-of-minute-ventilation-based-techniques-with-standard-fixed-fresh-gas-flow-technique
#28
RANDOMIZED CONTROLLED TRIAL
Anju Gupta, Priyankar K Datta
This study was done to ascertain the optimum fresh gas flow (FGF) offering the best balance between rapid induction and minimal waste in pediatric patients. Forty-five children (weighing 10-20 kg) undergoing elective procedures under general anesthesia were randomly assigned into 3 groups: 0.5 minute ventilation (MV), MV, and S (FGF = 6 L/min). After priming the pediatric closed circuit, anesthesia was induced using a face mask with 8% sevoflurane in 100% oxygen (Draeger Primus Vista 120 anesthesia machine) at FGF-determined MV per group allocation...
June 2020: AANA Journal
https://read.qxmd.com/read/32228201/minimally-invasive-aortic-valve-replacement-extracorporeal-circulation-optimization-and-minimally-invasive-extracorporeal-circulation-system-evolution
#29
JOURNAL ARTICLE
Roberto Carozza, Diego Fazzi, Armando Pietrini, Mariano Cefarelli, Francesca Mazzocca, Walter Vessella, Paolo Berretta, Monica Romagnoli, Jacopo Alfonsi, Hossein M Zahedi, Christopher Munch, Marco Di Eusanio
Treatment of aortic valve disease has become less and less invasive during the last years, thanks to progress in anesthesiology, surgical techniques, and perfusion management. In fact, it has been demonstrated that shorter skin incision, combined with ultra-fast-track anesthesia and minimized extracorporeal circuit could improve clinical outcomes. Current evidence shows that minimally invasive extracorporeal circulation system is associated with reduced red blood cells' transfusion rate, improved end-organ perfusion, decreased incidence of postoperative atrial fibrillation, air embolism leakage, and so less cerebral accidents with better neurological outcomes...
November 2020: Perfusion
https://read.qxmd.com/read/31920232/minimal-flow-anesthesia-can-be-initiated-early-with-the-use-of-higher-fresh-gas-flow-to-facilitate-desflurane-wash-in
#30
JOURNAL ARTICLE
Mukul Chandra Kapoor, Ayalasomayajula Sashank, Ashok Vats, Shaloo Garg, Archana Puri
BACKGROUND AND AIMS: More than 80% of delivered anesthetic gases get wasted at high fresh gas flows as they are vented out unused. Use of minimal flow anesthesia is associated with less waste anesthetic gas emission and environmental pollution. There is no approved or validated technique to initiate minimal flow anesthesia and simultaneously achieve denitrogenation of the breathing circuit. We studied the wash-in characteristics of desflurane, when delivered with 50% nitrous oxide, to reach a target end-tidal concentration at two different gas flow rates...
October 2019: Journal of Anaesthesiology, Clinical Pharmacology
https://read.qxmd.com/read/31452313/xenon-recovery-by-dd3r-zeolite-membranes-application-in-anaesthetics
#31
REVIEW
Xuerui Wang, Yuting Zhang, Xiaoyu Wang, Eduardo Andres-Garcia, Peng Du, Lorena Giordano, Lin Wang, Zhou Hong, Xuehong Gu, Sohail Murad, Freek Kapteijn
Xe is only produced by cryogenic distillation of air, and its availability is limited by the extremely low abundance. Therefore, Xe recovery after usage is the only way to guarantee sufficient supply and broad application. Herein we demonstrate DD3R zeolite as a benchmark membrane material for CO2 /Xe separation. The CO2 permeance after an optimized membrane synthesis is one order magnitude higher than for conventional membranes and is less susceptible to water vapour. The overall membrane performance is dominated by diffusivity selectivity of CO2 over Xe in DD3R zeolite membranes, whereby rigidity of the zeolite structure plays a key role...
October 21, 2019: Angewandte Chemie
https://read.qxmd.com/read/31277626/reducing-kidney-motion-optimizing-anesthesia-and-combining-respiratory-support-for-retrograde-intrarenal-surgery-a-pilot-study
#32
JOURNAL ARTICLE
Nariman Gadzhiev, Ullubiy Oibolatov, Leonid Kolotilov, Sergei Parvanyan, Gagik Akopyan, Sergei Petrov, Courtney M Cottone, John Sung, Zhamshid Okhunov
BACKGROUND: One of the greatest challenges presented with RIRS is the potential for movement of the stone within the operative field associated with diaphragm and chest respiratory excursions due to mechanical ventilation. To overcome this challenge, we propose in this pilot study a new general anesthesia technique combining high frequency jet ventilation (HFJV) with small volume mechanical ventilation (SVMV). Data regarding safety, feasibility and surgeons' impression was assessed. METHODS: Patients undergoing RIRS for kidney stones from November 2017 to May 2018 were prospectively recruited to participate in the study...
July 5, 2019: BMC Urology
https://read.qxmd.com/read/31192237/do-the-manual-or-computer-controlled-flowmeters-generate-similar-isoflurane-concentrations-in-tafonius
#33
JOURNAL ARTICLE
Mathieu Raillard, Olivier Levionnois, Paul MacFarlane
Introduction: Tafonius is an anesthesia machine with computer-controlled monitor and ventilator. We compared the isoflurane fluctuations in the circuit with manual (MF) or computer-driven (CF) flowmeters, investigated the origin of the differences and assessed whether isoflurane concentration time course followed a one-compartment model. Material and Methods: A calibrated TEC-3 isoflurane vaporizer was used. Gas composition and flows were measured using a multiparametric monitor and a digital flowmeter. Measurements included: (1) Effects of various Fi O2 with MF/CF on the isoflurane fraction changes in the breathing system during mechanical ventilation of a lung model; wash-in kinetic was fitted to a compartmental model; (2) Gas outflow at the common gas outlet (CGO) with MF/CF at different Fi O2 ; (3) Isoflurane output of the vaporizer at various dial settings with MF/CF set at different flows without and with reduction of the CGO diameter...
2019: Frontiers in Veterinary Science
https://read.qxmd.com/read/30925559/estimating-the-impact-of-carbon-dioxide-absorbent-performance-differences-on-absorbent-cost-during-low-flow-anesthesia
#34
JOURNAL ARTICLE
Jeffrey M Feldman, Christopher Lo, Jan Hendrickx
BACKGROUND: Reducing fresh gas flow when using a circle anesthesia circuit is the most effective strategy for reducing both inhaled anesthetic vapor cost and waste. As fresh gas flow is reduced, the amount of exhaled gas rebreathed increases, but the utilization of carbon dioxide absorbent increases as well. Reducing fresh gas flow may not make economic sense if the increased cost of absorbent utilization exceeds the reduced cost of anesthetic vapor. The primary objective of this study was to determine the minimum fresh gas flow at which absorbent costs do not exceed vapor savings...
February 2020: Anesthesia and Analgesia
https://read.qxmd.com/read/30489520/-brazilian-butt-lift-under-local-anesthesia-a-novel-technique-addressing-safety-concerns
#35
JOURNAL ARTICLE
Christopher T Chia, Spero J Theodorou, Erez Dayan, Georges Tabbal, Daniel Del Vecchio
BACKGROUND: The gluteal lift ("Brazilian butt lift") has improved significantly in technique and in outcomes. Some postulate that fat embolism occurs because of damage to veins superficial to the gluteus muscles and that fat must be injected intramuscularly to achieve satisfactory aesthetic results. The purpose of this article is to present data where gluteal lift is performed under local anesthesia, address safety concerns, and clarify these speculations. METHODS: All patients underwent gluteal lift under local anesthesia using oral medications and tumescent infiltration...
December 2018: Plastic and Reconstructive Surgery
https://read.qxmd.com/read/29750662/supplemental-carbon-dioxide-stabilizes-the-upper-airway-in-volunteers-anesthetized-with-propofol
#36
JOURNAL ARTICLE
Katarina Jennifer Ruscic, Janne Bøgh Stokholm, Johann Patlak, Hao Deng, Jeroen Cedric Peter Simons, Timothy Houle, Jürgen Peters, Matthias Eikermann
BACKGROUND: Propofol impairs upper airway dilator muscle tone and increases upper airway collapsibility. Preclinical studies show that carbon dioxide decreases propofol-mediated respiratory depression. We studied whether elevation of end-tidal carbon dioxide (PETCO2) via carbon dioxide insufflation reverses the airway collapsibility (primary hypothesis) and impaired genioglossus muscle electromyogram that accompany propofol anesthesia. METHODS: We present a prespecified, secondary analysis of previously published experiments in 12 volunteers breathing via a high-flow respiratory circuit used to control upper airway pressure under propofol anesthesia at two levels, with the deep level titrated to suppression of motor response...
July 2018: Anesthesiology
https://read.qxmd.com/read/28831619/important-role-of-calcium-chloride-in-preventing-carbon-monoxide-generation-during-desflurane-degradation-with-alkali-hydroxide-free-carbon-dioxide-absorbents
#37
JOURNAL ARTICLE
Takahiro Ando, Atsushi Mori, Rie Ito, Kimitoshi Nishiwaki
We investigated whether calcium chloride (CaCl2 ), a supplementary additive in carbon dioxide (CO2 ) absorbents, could affect carbon monoxide (CO) production caused by desflurane degradation, using a Japanese alkali-free CO2 absorbent Yabashi Lime® -f (YL-f), its CaCl2 -free and 1% CaCl2 -added derivatives, and other commercially available alkali-free absorbents with or without CaCl2 . The reaction between 1 L of desflurane gas (3-10%) and 20 g of desiccated specimen was performed in an artificial closed-circuit anesthesia system for 3 min at 20 or 40 °C...
December 2017: Journal of Anesthesia
https://read.qxmd.com/read/28743752/thalamocortical-synchronization-during-induction-and-emergence-from-propofol-induced-unconsciousness
#38
JOURNAL ARTICLE
Francisco J Flores, Katharine E Hartnack, Amanda B Fath, Seong-Eun Kim, Matthew A Wilson, Emery N Brown, Patrick L Purdon
General anesthesia (GA) is a reversible drug-induced state of altered arousal required for more than 60,000 surgical procedures each day in the United States alone. Sedation and unconsciousness under GA are associated with stereotyped electrophysiological oscillations that are thought to reflect profound disruptions of activity in neuronal circuits that mediate awareness and cognition. Computational models make specific predictions about the role of the cortex and thalamus in these oscillations. In this paper, we provide in vivo evidence in rats that alpha oscillations (10-15 Hz) induced by the commonly used anesthetic drug propofol are synchronized between the thalamus and the medial prefrontal cortex...
August 8, 2017: Proceedings of the National Academy of Sciences of the United States of America
https://read.qxmd.com/read/28614132/the-effect-of-chronic-opioid-use-on-end-tidal-concentration-of-sevoflurane-necessary-to-maintain-a-bispectral-index-below-50-a-prospective-single-blind-study
#39
COMPARATIVE STUDY
Tak Kyu Oh, Woosik Eom, Jiyeon Yim, Namwoo Kim, Kyungho Kwon, Seong-Eun Kim, Dae Hyun Kim
BACKGROUND: Opioid analgesics decrease the minimum alveolar concentration of inhalation agents during the acute phase response. However, the effect of chronic opioid exposure on minimum alveolar concentration of inhalation agents remains unknown. This study aimed to determine the concentration of sevoflurane necessary to maintain a bispectral index (BIS) <50 (SEVOBIS50) in patients with chronic opioid use compared with those naïve to opioid use. METHODS: We included chronic opioid users who received a stable dose of oral morphine of at least 60 mg/d according to the morphine equivalent daily dose for at least 4 weeks and opioid-naïve patients...
July 2017: Anesthesia and Analgesia
https://read.qxmd.com/read/28611601/lack-of-responsiveness-during-the-onset-and-offset-of-sevoflurane-anesthesia-is-associated-with-decreased-awake-alpha-oscillation-power
#40
JOURNAL ARTICLE
Kara J Pavone, Lijuan Su, Lei Gao, Ersne Eromo, Rafael Vazquez, James Rhee, Lauren E Hobbs, Reine Ibala, Gizem Demircioglu, Patrick L Purdon, Emery N Brown, Oluwaseun Akeju
Anesthetic drugs are typically administered to induce altered states of arousal that range from sedation to general anesthesia (GA). Systems neuroscience studies are currently being used to investigate the neural circuit mechanisms of anesthesia-induced altered arousal states. These studies suggest that by disrupting the oscillatory dynamics that are associated with arousal states, anesthesia-induced oscillations are a putative mechanism through which anesthetic drugs produce altered states of arousal. However, an empirical clinical observation is that even at relatively stable anesthetic doses, patients are sometimes intermittently responsive to verbal commands during states of light sedation...
2017: Frontiers in Systems Neuroscience
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