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https://www.readbyqxmd.com/read/29417750/does-gradual-change-in-head-positioning-affect-cerebrovascular-physiology
#1
Man Y Lam, Victoria J Haunton, Thompson G Robinson, Ronney B Panerai
We studied cerebral blood velocity (CBV), and associated hemodynamic parameters during gradual changes in head positioning in a nonstroke group. CBV (transcranial Doppler ultrasound), beat-to-beat blood pressure (BP, Finometer), and end-tidal carbon dioxide (ETCO2 , capnography) were recorded between lying flat (0°) and sitting up (30°) head positions, in 18 volunteers (10 female, mean age, 57 ± 16 years), at two visits (12 ± 8 days). A significant reduction was found between 5-min FLAT (0°) and 5-min SIT (30°) positions in CBV (visit 1: 4...
February 2018: Physiological Reports
https://www.readbyqxmd.com/read/29395694/a-rare-airway-obstruction-caused-by-dissection-of-a-reinforced-endotracheal-tube
#2
Yoon Hee Choi, Dong Hoon Lee
BACKGROUND: Endotracheal tube (ETT) obstruction or narrowing in patients undergoing general anesthesia due to dissection of reinforced ETT is unusual. CASE REPORT: A 26-year-old woman was transferred to the emergency department due to drowsy mental status after surgery. She was intubated by reinforced ETT with grossly normal external appearance, but the inner layer of ETT was dissected, the inner diameter was narrowed, and the extent of protrusion of inner layer of ETT was more severe at the distal end...
January 29, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29383314/controlled-vs-spontaneous-ventilation-for-bronchoscopy-in-children-with-tracheobronchial-foreign-body
#3
Leila Mashhadi, Alireza Sabzevari, Mohammad Gharavi Fard, Reza Shojaeian, Maryam Salehi, Marjan Joodi, Mahdi Fathi, Ali Jafarzadeh Esfehani, Kamran Khazaeni
Introduction: Tracheobronchial foreign body aspiration is a common life-threatening condition in children. There are controversies in the management of this condition, including the type of ventilation during bronchoscopy. This study aims to compare anesthesia with controlled ventilation versus spontaneous ventilation in rigid bronchoscopy in children with foreign body aspiration. Materials and Methods: Patients who were candidates for rigid bronchoscopy due to foreign body aspiration were randomly assigned to either anesthesia with spontaneous ventilation or controlled ventilation...
November 2017: Iranian Journal of Otorhinolaryngology
https://www.readbyqxmd.com/read/29381171/pilot-study-of-educational-gaming-to-improve-adherence-to-an-end-tidal-carbon-dioxide-monitoring-protocol
#4
Taylore D Jansen, Sonja Stutzman, Christine Yu, David Parry, DaiWai M Olson
BACKGROUND: End-tidal carbon dioxide (ETCO2) monitoring is an important part of patient care. Understanding and interpreting ETCO2 wavelengths can be a challenge. This pilot study explored the efficacy of a novel approach to educating clinicians on ETCO2 monitoring via game theory. METHOD: A video game application for ETCO2 monitoring was developed. Clinicians were encouraged to play the game over a 3-month period. Compliance with the ETCO2 protocol was compared in a random selection of patients admitted before, during, and after the intervention...
February 1, 2018: Journal of Continuing Education in Nursing
https://www.readbyqxmd.com/read/29367357/seesawing-end-tidal-carbon-dioxide-portent-of-critical-carbon-dioxide-embolism-in-retroperitoneoscopy
#5
Melvin Alex Abraham, Riya Jose, Mazhuvanchary Jacob Paul
An abrupt increase in end-tidal CO2 (EtCO2; from 35 to 58 mm Hg) followed by a sudden fall (to 18 mm Hg) was noted during retroperitoneoscopic adrenalectomy under general anaesthesia in a 23-year-old patient with adrenal hyperplasia. This was accompanied by hypotension (systolic blood pressure of 60 mm Hg), desaturation (88% SpO2) and ST depression (3.5 mm). The patient was resuscitated with fluids and vasopressor drugs and about 4 mL of air was aspirated through the central venous catheter, confirming the diagnosis of an intraoperative gas embolism...
January 23, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29359072/efficacy-and-safety-of-using-high-flow-nasal-oxygenation-in-patients-undergoing-rapid-sequence-intubation
#6
Santi Maurizio Raineri, Andrea Cortegiani, Giuseppe Accurso, Claudia Procaccianti, Filippo Vitale, Sabrina Caruso, Antonino Giarratano, Cesare Gregoretti
Objective: To assess the efficacy and safety of high-flow nasal oxygen (HFNO) therapy in patients undergoing rapid sequence intubation (RSI) for emergency abdominal surgery. Methods: HFNO of 60 L.min-1 at an inspiratory oxygen fraction of 1 was delivered 4 min before laryngoscopy and maintained until the patient was intubated, and correct intubation was verified by the appearance of the end-tidal CO2 (EtCO2) waveform. Transcutaneous oxygenation (SpO2), heart rate and non-invasive mean arterial pressure were monitored at baseline (T0), after 4 min on HFNO (T1) and at the time of laryngoscopy (T2) and endotracheal intubation (ETI) (T3)...
December 2017: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/29340812/partial-amniotic-carbon-dioxide-insufflation-paci-during-minimally-invasive-fetoscopic-interventions-on-fetuses-with-spina-bifida-aperta
#7
Miriam Ziemann, Rolf Fimmers, Anastasiia Khaleeva, Rainer Schürg, Markus A Weigand, Thomas Kohl
BACKGROUND: Percutaneous partial amniotic carbon dioxide insufflation (PACI) is one of the most important means for improving visualization during minimally invasive fetoscopic surgery of fetal spina bifida. The purpose of the present study was to analyze maternal and fetal safety aspects of PACI in a recent patient cohort and to present management improvements. METHODS: PACI under general materno-fetal anesthesia was performed during 65 interventions for fetoscopic patch coverage of fetal spina bifida aperta between 21 + 0 and 29 + 1 weeks of gestation...
January 16, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29340799/fully-automated-life-support-an-implementation-and-feasibility-pilot-study-in-healthy-pigs
#8
Wilfried Klingert, Jörg Peter, Christian Thiel, Karolin Thiel, Wolfgang Rosenstiel, Kathrin Klingert, Christian Grasshoff, Alfred Königsrainer, Martin Schenk
BACKGROUND: Automated systems are available in various application areas all over the world for the purpose of reducing workload and increasing safety. However, such support systems that would aid caregivers are still lacking in the medical sector. With respect to workload and safety, especially, the intensive care unit appears to be an important and challenging application field. Whereas many closed-loop subsystems for single applications already exist, no comprehensive system covering multiple therapeutic aspects and interactions is available yet...
January 16, 2018: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/29321118/a-comparison-of-carotid-doppler-ultrasonography-and-capnography-in-evaluating-the-efficacy-of-cardiopulmonary-resuscitation-the-first-study
#9
Gökhan Yilmaz, Mustafa Silcan, Süha Serin, Bahadır Caglar, Özkan Erarslan, İsmet Parlak
INTRODUCTION AND PURPOSE: The end-tidal carbon dioxide (ETCO2) measurement is accepted as the gold standard method for assessing cardiopulmonary resuscitation (CPR) efficacy. In recent studies, the use of Carotid Doppler Ultrasonography has become widespread in showing CPR efficacy. In the present study, the carotid blood flow measurement was compared with ETCO2 measurement and an evaluation was made of whether this method could be used as an alternative method to capnography in the assessment of CPR efficacy...
January 6, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29315308/mac-sparing-effect-of-nitrous-oxide-in-sevoflurane-anesthetized-sheep-and-its-reversal-with-systemic-atipamezole-administration
#10
Lauren Duffee, Nicolò Columbano, Antonio Scanu, Valentino Melosu, Giovanni Mario Careddu, Giovanni Sotgiu, Bernd Driessen
INTRODUCTION: Nitrous oxide (N2O) is an anesthetic gas with antinociceptive properties and reduces the minimum alveolar concentration (MAC) for volatile anesthetic agents, potentially through mechanisms involving central alpha2-adrenoceptors. We hypothesized that 70% N2O in the inspired gas will significantly reduce the MAC of sevoflurane (MACSEVO) in sheep, and that this effect can be reversed by systemic atipamezole. MATERIALS AND METHODS: Animals were initially anesthetized with SEVO in oxygen (O2) and exposed to an electrical current as supramaximal noxious stimulus in order to determine MACSEVO (in duplicates)...
2018: PloS One
https://www.readbyqxmd.com/read/29306241/the-relationship-between-the-trendelenburg-position-and-cerebral-hypoxia-inpatients-who-have-undergone-robot-assisted-hysterectomy-and-prostatectomy
#11
Ali Özgün, Asuman Sargın, Semra Karaman, İlkben Günüşen, Işık Alper, Fatma Zekiye Aşkar
Background/aim: This study aimed to evaluate the relationship between the Trendelenburg position and cerebral hypoxia in robot-assisted hysterectomy and prostatectomy.Materials and methods: A standardized mini-mental state examination was administered to 50 patients enrolled in the study 1 h before and after surgery. Near infrared spectroscopy (NIRS) values and hemodynamic and respiratory parameters were recorded after induction of anesthesia (baseline) and once every 20 min in the Trendelenburg position and supine positions...
December 19, 2017: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/29296053/nonfatal-pulmonary-embolism-associated-with-the-use-of-compression-stockings-in-the-lithotomy-position-after-spinal-anesthesia
#12
I-Wen Chen, Cheuk-Kwan Sun, Jen-Yin Chen, Chien-Ming Lin, Kuo-Chuan Hung
A 73-year-old male (height, 156 cm; body weight, 51 kg), without a history of cardiovascular disease or thromboembolic events, was scheduled for transurethral resection of the prostate under spinal anesthesia. Spinal anesthesia was administered with hyperbaric bupivacaine, resulting in an upper anesthetic level of T6. Before surgery, compression stockings were applied to both lower limbs, and the patient was placed in the lithotomy position. Approximately 15 min later, he complained of intolerable chest tightness, followed by tachycardia (heart rate, 110 beats/min) and desaturation (oxygen saturation [SaO2], 90%)...
October 2017: Ci Ji Yi Xue za Zhi, Tzu-chi Medical Journal
https://www.readbyqxmd.com/read/29284856/proseal-laryngeal-mask-airway-versus-cuffed-endotracheal-tube-for-laparoscopic-surgical-procedures-under-general-anesthesia-a-random-comparative-study
#13
Suchita Shailesh Parikh, Shivam Bipin Parekh, Chaula Doshi, Varsha Vyas
Context: The Proseal LMA(PLMA), which has been designed especially for positive pressure ventilation and protection against aspiration can act as an alternative to Endotracheal Tube (ETT) as an effective airway device for patients undergoing elective Laparoscopic surgeries. Aims: To compare the efficacy and safety of PLMA with ETT in patients undergoing Laparoscopic surgeries under general anaesthesia. Settings and Design: A prospective, randomized study was conducted in a tertiary care teaching hospital with 60 patients of ASA grade I/II undergoing elective Laparoscopic surgery under general anaesthesia...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29261592/whole-blood-and-hextend-bookends-of-modern-tactical-combat-casualty-care-field-resuscitation-and-starting-point-for-multi-functional-resuscitation-fluid-development
#14
Forest R Sheppard, Thomas A Mitchell, Antoni R Macko, Darren M Fryer, Leasha J Schaub, Kassandra M Ozuna, Jacob J Glaser
BACKGROUND: Hemorrhage is the leading cause of preventable death in traumatically injured civilian and military populations. Pre-hospital resuscitation largely relies on crystalloid and colloid intra-vascular expansion, as whole blood and component blood therapy are logistically arduous. In this experiment, we evaluated the bookends of Tactical Combat Casualty Care Guidelines recommendations of pre-hospital resuscitation with Hextend and whole blood in a controlled hemorrhagic shock model within non-human primates, as means of a multi-functional resuscitative fluid development...
December 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29217394/the-use-of-end-tidal-carbon-dioxide-etco2-measurement-to-guide-management-of-cardiac-arrest-a-systematic-review
#15
REVIEW
Edison F Paiva, James H Paxton, Brian J O'Neil
AIMS: To identify whether any level of end-tidal carbon dioxide (ETCO2) measured during cardiopulmonary resuscitation (CPR) correlates with return of spontaneous circulation (ROSC) or survival in adults experiencing cardiac arrest in any setting. METHODS: Systematic review. We included randomized controlled trials, cohort studies, and case-control studies of adult cardiac arrest in any setting that reported specific (rather than pooled) ETCO2 values and attempted to correlate those values with prognosis...
December 4, 2017: Resuscitation
https://www.readbyqxmd.com/read/29210902/insufflation-with-carbon-dioxide-during-pediatric-colonoscopy-for-control-of-postprocedure-pain
#16
Chad Thornhill, Fernando Navarro, Baraa Alabd Alrazzak, S Shahrukh Hashmi, Ashish N DebRoy, Jon M Rhoads, Essam Imseis
GOALS: To determine if carbon dioxide (CO2) insufflation in children would improve postprocedure pain following colonoscopy in children. BACKGROUND: CO2 insufflation during colonoscopy has been found to reduce postcolonoscopy pain in the adult population, but limited data exist in pediatrics. MATERIALS AND METHODS: We conducted a prospective study with 40 pediatric patients scheduled for outpatient colonoscopy. Patients were enrolled continuously and were randomized to receive CO2 or air insufflation...
November 28, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/29207810/comparative-study-of-the-effect-of-dexmedetomidine-vs-fentanyl-on-haemodynamic-response-in-patients-undergoing-elective-laparoscopic-surgery
#17
Jayshree P Vaswani, Debasis Debata, Varsha Vyas, Surekha Pattil
Introduction: Dexmedetomidine and fentanyl, both have sedative and analgesic effects. They are often used as adjunct during anaesthesia to attenuate pressor response during tracheal intubation. Limited study has been done comparing the effect of both drugs on haemodynamic response in patients undergoing laparoscopic surgery. Aim: The study was designed to compare the effect of dexmedetomidine Vs fentanyl on haemodynamic response to tracheal intubation, following pneumoperitoneum and intraoperative period in patients undergoing laparoscopic surgery...
September 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/29190801/comparison-between-manual-and-mechanical-chest-compressions-during-resuscitation-in-a-pediatric-animal-model-of-asphyxial-cardiac-arrest
#18
COMPARATIVE STUDY
Jorge López, Sarah N Fernández, Rafael González, María J Solana, Javier Urbano, Blanca Toledo, Jesús López-Herce
AIMS: Chest compressions (CC) during cardiopulmonary resuscitation are not sufficiently effective in many circumstances. Mechanical CC could be more effective than manual CC, but there are no studies comparing both techniques in children. The objective of this study was to compare the effectiveness of manual and mechanical chest compressions with Thumper device in a pediatric cardiac arrest animal model. MATERIAL AND METHODS: An experimental model of asphyxial cardiac arrest (CA) in 50 piglets (mean weight 9...
2017: PloS One
https://www.readbyqxmd.com/read/29189269/comparison-of-transcranial-doppler-and-ultrasound-tagged-near-infrared-spectroscopy-for-measuring-relative-changes-in-cerebral-blood-flow-in-human-subjects
#19
Michael S Lipnick, Elizabeth A Cahill, John R Feiner, Philip E Bickler
BACKGROUND: Currently, no reliable method exists for continuous, noninvasive measurements of absolute cerebral blood flow (CBF). We sought to determine how changes measured by ultrasound-tagged near-infrared spectroscopy (UT-NIRS) compare with changes in CBF as measured by transcranial Doppler (TCD) in healthy volunteers during profound hypocapnia and hypercapnia. METHODS: Ten healthy volunteers were monitored with a combination of TCD, UT-NIRS (c-FLOW, Ornim Medical), as well as heart rate, blood pressure, end-tidal PCO2 (PEtCO2), end-tidal O2, and inspired O2...
November 14, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29187557/the-assessment-of-neurovascular-coupling-with-the-addenbrooke-s-cognitive-examination-a-functional-transcranial-doppler-ultrasonographic-study
#20
Lucy C Beishon, Claire A L Williams, Ronney B Panerai, Thompson G Robinson, Victoria Joanna Haunton
Cerebrovascular dysfunction occurs early in dementia and can be identified by Transcranial Doppler ultrasonography (TCD). Few studies have examined cerebral blood flow velocity (CBFv) responses to a detailed cognitive battery. This study aimed to characterise all CBFv responses, and the effect of hemispheric dominance, to the Addenbrooke's Cognitive Examination (ACE-III) in healthy volunteers. Forty volunteers underwent continuous bilateral TCD, beat-to-beat blood pressure (MAP) (Finapres), heart rate (HR) (electrocardiogram), and end-tidal CO2 (ETCO2) (capnography) monitoring...
November 29, 2017: Journal of Neurophysiology
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