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https://www.readbyqxmd.com/read/29239956/the-anesthesia-workstation-quo-vadis
#1
Jan F A Hendrickx, Andre M De Wolf
Ensuring adequate ventilation and oxygenation and delivering inhaled anesthetic agent to the patient remain core responsibilities of the anesthesia provider during general anesthesia. Because of the emphasis placed on physiology, pharmacology, clinical sciences, and administrative duties, the stellar anesthesia workstation technology may be underutilized by the anesthesia community. Target-controlled O2 and agent delivery and automated end-expired CO2 control have entered the clinical arena, with only cost, luddism, and administrative hurdles preventing their more widespread use...
December 11, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29238880/in-vitro-performance-of-prefilled-co2-absorbers-with-the-zeus%C3%A2
#2
Mohab Omer, Jan F A Hendrickx, Simon De Ridder, Alexander De Houwer, Rik Carette, Sofie De Cooman, Andre M De Wolf
Low fresh gas flows (FGFs) decrease the use of anesthetic gases, but increase CO2 absorbent usage. CO2 absorbent usage remains poorly quantified. The goal of this study is to determine canister life of 8 commercially available CO2 absorbent prepacks with the Zeus®. Pre-packed CO2 canisters of 8 different brands were tested in vitro: Amsorb Plus, Spherasorb, LoFloSorb, LithoLyme, SpiraLith, SpheraSorb, Drägersorb 800+, Drägersorb Free, and CO2ntrol. CO2 (160 mL min- 1) flowed into the tip of a 2 L breathing bag that was ventilated with a tidal volume of 500 mL, a respiratory rate of 10/min, and an I:E ratio of 1:1 using the controlled mechanical ventilation mode of the Zeus® (Dräger, Lubeck, Germany)...
December 13, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29233951/exposure-assessment-biological-monitoring-and-liver-function-tests-of-operating-room-personnel-exposed-to-halothane-in-hamedan-hospitals-west-of-iran
#3
Mohammad Hossien Bakhshaei, Abdorrahman Bahrami, Amin Mirzakhani, Hossien Mahjub, Mohammad Javad Assari
BACKGROUND: Occupational exposure to halogenated hydrocarbons has been associated with halothane hepatitis, an increase of liver enzymes, and congenital malformations. The objectives of this study were to investigate whether bromide, a urinary metabolite of halothane, could be used as a biological marker of exposure to this anesthetic gas and assessment of associated exposure to halothane with any significant changes in conventional parameters of liver function (serum aminotransferase activities)...
November 4, 2017: Journal of Research in Health Sciences
https://www.readbyqxmd.com/read/29210379/porous-dipeptide-crystals-as-volatile-drug-vessels
#4
S Bracco, D Asnaghi, M Negroni, P Sozzani, A Comotti
Porous crystalline dipeptides absorb, reversibly from the gas phase, a series of volatile fluorinated ethers in use as anesthetics. Their vapor pressure was considerably reduced, with favorable guest capture and release. Variable channel sizes were customized for selective sorption and pressure thresholds were observed in the narrowest pores. 1H, 13C and 19F MAS NMR coupled with ab initio conformational analysis and grand canonical Monte Carlo simulations highlight the guest loading and arrangement adopted in the congruent nanochannels, suggesting how the anesthetics can accommodate in biochemical receptors...
December 6, 2017: Chemical Communications: Chem Comm
https://www.readbyqxmd.com/read/29199541/impact-of-temperature-on-the-narcotrend-index-during-hypothermic-cardiopulmonary-bypass-in-children-with-sevoflurane-anesthesia
#5
Nils Dennhardt, Christiane Beck, Dietmar Boethig, Sebastian Heiderich, Alexander Horke, Sebastian Tiedge, Martin Boehne, Robert Sümpelmann
BACKGROUND: During cardiopulmonary bypass (CPB) in children, anesthesia maintained by sevoflurane administered via the oxygenator is increasingly common. Anesthetic uptake and requirement may be influenced by the non-physiological conditions during hypothermic CPB. Narcotrend-processed EEG monitoring may, therefore, be useful to guide the administration of sevoflurane during this phase. OBJECTIVE: The objective of this prospective, clinical, observational study was to assess the correlation between body temperature, Narcotrend Index (NI) and administered sevoflurane in children during CPB...
December 1, 2017: Perfusion
https://www.readbyqxmd.com/read/29169225/a-comparison-of-the-effects-of-isoflurane-versus-propofol-remifentanil-anesthesia-on-oxygen-delivery-during-thoracoscopic-lung-lobectomy-with-one-lung-ventilation-in-dogs
#6
Jiyoung Park, Hae-Beom Lee, Seong Mok Jeong
This study compared effects of isoflurane inhalation (ISO) and propofol-remifentanil combined total intravenous anesthesia (TIVA) on oxygenation during thoracoscopic lung lobectomy with 30-minute one-lung ventilation (1LV). Thoracoscopic right middle lung lobectomy was performed in ten dogs divided into ISO and TIVA group and cardiopulmonary parameters were measured with blood gas analysis. Throughout the study, isoflurane was inhaled up to 1.5%, and the infusion rates of propofol and remifentanil were 0.2~0...
November 23, 2017: Journal of Veterinary Science
https://www.readbyqxmd.com/read/29159929/s100%C3%AE-in-newborns-after-c-section-with-general-vs-epidural-anesthesia-a-prospective-observational-study
#7
Z Xu, Z Liu, Y Zhang, C Jin, F Shen, Y Yu, T Cheek, O Onuoha, G Liang, R Month, J Atkins, K M Tran, H Wei
BACKGROUND: Preclinical evidence suggests that general anesthetics can dose dependently induce neurodegeneration in the developing brains of animals which can be reliably determined by measurement of blood S100β, but this correlation remains unclear in humans. We hypothesized that S100β would not be increased in cord arterial blood of fetuses exposed briefly to general anesthetics during a C-section, compared with epidural anesthesia. METHODS: A prospective observational clinical study comparatively measured changes of brain damage biomarker S100β ratio of umbilical artery over vein (changes after fetus circulation) immediately after delivery under C-section with either epidural or general anesthesia...
November 20, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29150782/nitrous-oxide-added-at-the-end-of-isoflurane-anesthesia-hastens-early-recovery-without-increasing-the-risk-for-postoperative-nausea-and-vomiting-a-randomized-clinical-trial
#8
Boris Mraovic, Tatjana Simurina, Tong J Gan
BACKGROUND: Nitrous oxide (N2O) has been reported to increase the risk of postoperative nausea and vomiting (PONV) in a dose-dependent manner. We investigated the effect of adding N2O at the end of isoflurane inhalational anesthesia on the recovery and incidence of PONV. Our hypothesis was that N2O would reduce the time to early recovery without increasing the incidence of PONV. METHODS: After obtaining ethics committee approval and written informed consent, 100 women at American Society of Anesthesiologists physical status I-III and scheduled for laparoscopic-assisted vaginal hysterectomy were randomized into two groups (G) according to the carrier gas: GO2 (air in 30% oxygen) and GN2O (the same mixture until the last 30 min of surgery, when 70% N2O in 30% oxygen was used)...
November 17, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29138115/active-forms-of-akt-and-erk-are-dominant-in-the-cerebral-cortex-of-newborn-pigs-that-are-unaffected-by-asphyxia
#9
Viktória Kovács, Valéria Tóth-Szűki, János Németh, Viktória Varga, Gábor Remzső, Ferenc Domoki
AIMS: Perinatal asphyxia (PA) often results in hypoxic-ischemic encephalopathy (HIE) in term neonates. Introduction of therapeutic hypothermia improved HIE outcome, but further neuroprotective therapies are still warranted. The present study sought to determine the feasibility of the activation of the cytoprotective PI-3-K/Akt and the MAPK/ERK signaling pathways in the subacute phase of HIE development in a translational newborn pig PA/HIE model. MAIN METHODS: Phosphorylated and total levels of Akt and ERK were determined by Western blotting in brain samples obtained from untreated naive, time control, and PA/HIE animals at 24-48h survival (n=3-3-6,respectively)...
November 11, 2017: Life Sciences
https://www.readbyqxmd.com/read/29108049/body-fat-of-stock-type-horses-predicted-by-rump-fat-thickness-and-deuterium-oxide-dilution-and-validated-by-near-infrared-spectroscopy-of-dissected-tissues
#10
E N Ferjak, C A Cavinder, D D Burnett, C Mc Argo, T T N Dinh
Body condition score and percent body fat (BF; %) of horses are positively correlated with reproductive efficiency and are indicative of metabolic issues. However, BF in horses may be poorly predicted because current procedures are either subjective or dependent on one anatomical location. Therefore, the objectives of the current study were to compare 2 methods of predicting BF using rump fat thickness (RFT) and deuterium oxide (DO) dilution with actual tissue fat analysis by near-infrared spectroscopy (NIRS) in stock-type horses and to identify the relationship between BF and BCS...
October 2017: Journal of Animal Science
https://www.readbyqxmd.com/read/29104694/health-effects-associated-with-exposure-to-anesthetic-gas-nitrous-oxide-n2o-in-clinical-hospital-shtip-personel
#11
Bilijana Eftimova, Marija Sholjakova, Dejan Mirakovski, Marija Hadzi-Nikolova
AIM: To show certain health effects associated with acute and chronic exposure to nitrous oxide of staff of the Department of Anaesthesiology and Intensive Care at the Clinical Hospital in Shtip. METHODS: A transversal study was conducted, that include 43 health workers (23 - exposed and 20 - unexposed). Personal exposure to nitrous oxide for this group members was assessed through continuous measurement over 8 hours shift within breathing zone of the subjects involved, using handheld electrochemical instrument with datalogging option direct...
October 15, 2017: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/29099261/effect-of-blood-collection-by-the-push-pull-technique-from-an-indwelling-catheter-versus-direct-venipuncture-on-venous-blood-gas-values-before-and-after-administration-of-alfaxalone-or-propofol-in-dogs
#12
Ciara A Barr, Giacomo Gianotti, Carly E Graffeo, Kenneth J Drobatz, Deborah C Silverstein
OBJECTIVE To compare the effect of blood collection by a push-pull technique from an indwelling IV catheter versus direct venipuncture on venous blood gas values before and after administration of alfaxalone or propofol to dogs. DESIGN Prospective randomized clinical study. ANIMALS 30 healthy client-owned dogs that weighed ≥ 10 kg (22 lb) and were anesthetized for elective surgical procedures. PROCEDURES All dogs were premedicated with methadone (0.5 mg/kg [0.2 mg/lb], IM), and 20 to 30 minutes later, anesthesia was induced with either alfaxalone (1 to 3 mg/kg [0...
November 15, 2017: Journal of the American Veterinary Medical Association
https://www.readbyqxmd.com/read/29083962/a-case-report-of-personal-exposures-to-isoflurane-during-animal-anesthesia-procedures
#13
James Fay
The purpose of this study was to compare personal exposures to isoflurane from participants' breathing zone samples during animal anesthesia procedures by the method of anesthetic gas delivery and the waste anesthetic gas (WAG) control method utilized. WAG control methods included passive scavenging using charcoal canisters, active scavenging using a building vacuum system, and various local exhaust ventilation systems such as laboratory fume hoods and capture hoods. Methods of anesthesia delivery included induction chambers, face masks (also known as nose cones), and intubation...
October 30, 2017: Journal of Occupational and Environmental Hygiene
https://www.readbyqxmd.com/read/29081093/-the-protective-effect-of-n-acetylcysteine-on-acute-lung-injury-induced-by-pfib-inhalation
#14
L M Yang, J Zhao, H T Wang, X X Xu, Y M JIiao, R G Ding
Objective: To study the protective effect of N-acetylcysteine on acute lung injury induced by PFIB inhalation and its mechanism. Methods: Survival experiment: 48 male ICR (CD-1) mice were randomly divided into 4 groups, i. e., PFIB control group, NAC prevention group, NAC treatment group, and NAC prevention + treatment group, each group contains 12 animals. The mice of PFIB C group were exposed to PFIB without any treatment. The mice of NAC P group were exposed to PFIB 30min after NAC administration. The mice of NAC T group were exposed to PFIB 1h before NAC administration, The mice of NAC P+T group were administrated with NAC twice (30 min before and 1h after PFIB inhalation) ...
July 20, 2017: Chinese Journal of Industrial Hygiene and Occupational Diseases
https://www.readbyqxmd.com/read/29076947/left-versus-biventricular-assist-devices-in-cardiac-arrest
#15
Erik J S Packer, Grete Slettom, Atle Solholm, Arve Mongstad, Rune Haaverstad, Vegard Tuseth, Ketil Grong, Jan Erik Nordrehaug
Maintaining adequate organ perfusion during cardiac arrest remains a challenge, and various assist techniques have been evaluated. We assessed whether a right ventricular impeller assist device (RVAD) in adjunct to a left ventricular impeller assist device (LVAD) is beneficial. Twenty anesthetized pigs were randomized to maximized circulatory support by percutaneously implanted left- or biventricular assist device(s) during 30 minutes of electrically induced ventricular fibrillation followed by three attempts of cardioversion...
October 20, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29076367/maternal-and-fetal-effects-of-dexmedetomidine-infusion-in-pregnant-ewes-anesthetized-with-sevoflurane
#16
Mauricio Loría Lépiz, Rebecca Sayre, Onkar Sawant, James Barr, Medora Pashmakova, Kevin Washburn, Shannon Washburn
OBJECTIVE To characterize the maternal and fetal cardiopulmonary effects of a low-dose infusion of dexmedetomidine without a loading dose in pregnant ewes anesthetized with sevoflurane. ANIMALS 11 pregnant ewes. PROCEDURES Anesthesia was induced with propofol and maintained with sevoflurane. Ewes and fetuses were instrumented with arterial and venous catheters, and thermodilution-pulmonary arterial catheters were placed in the ewes. Baseline measurements were obtained at an end-tidal sevoflurane concentration of 3...
November 2017: American Journal of Veterinary Research
https://www.readbyqxmd.com/read/29044830/optimal-management-of-apparatus-dead-space-in-the-anesthetized-infant
#17
REVIEW
Michael R King, Jeffrey M Feldman
Mechanical ventilation of the anesthetized infant requires careful attention to equipment and ventilator settings to assure optimal gas exchange and minimize the potential for lung injury. Apparatus dead space, defined as dead space resulting from devices placed between the endotracheal tube and the Y-piece of the breathing circuit, is the primary source of dead space controlled by the clinician. Due to the small tidal volumes required by infants and neonates, it is easy to create excessive apparatus dead space resulting in unintended hypercarbia or increased minute ventilation in an effort to achieve a desirable PCO2 ...
October 17, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28994673/an-innovative-technique-to-improve-safety-of-volatile-anesthetics-suction-from-the-cardiopulmonary-bypass-circuit
#18
Francesco De Simone, Luigi Cassarà, Salvatore Sardo, Elena Scarparo, Omar Saleh, Caetano Nigro Neto, Alberto Zangrillo, Giovanni Landoni
CONTEXT: Myocardial injury during cardiac surgery on cardiopulmonary bypass (CPB) is a major determinant of morbidity and mortality. Preclinical and clinical evidence of dose- and time-related cardioprotective effects of volatile anesthetic drugs exist and their use during the whole surgery duration could improve perioperative cardiac protection. Even if administering volatile agents during CPB are relatively easy, technical problems, such as waste gas scavenging, may prevent safe and manageable administration of halogenated vapors during CPB...
October 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28973329/the-ability-of-nitric-oxide-to-lower-intraocular-pressure-is-dependent-on-guanylyl-cyclase
#19
Stefan Muenster, Wolfgang S Lieb, Gregor Fabry, Kaitlin N Allen, Shivani S Kamat, Ann H Guy, Ana C Dordea, Leandro Teixeira, Robert E Tainsh, Binglan Yu, Wei Zhu, Nicole E Ashpole, Rajeev Malhotra, Peter Brouckaert, Donald B Bloch, Marielle Scherrer-Crosbie, W Daniel Stamer, Markus H Kuehn, Louis R Pasquale, Emmanuel S Buys
Purpose: While nitric oxide (NO) donors are emerging as treatments for glaucoma, the mechanism by which NO lowers intraocular pressure (IOP) is unclear. NO activates the enzyme guanylyl cyclase (GC) to produce cyclic guanosine monophosphate. We studied the ocular effects of inhaled and topically applied NO gas in mice and lambs, respectively. Methods: IOP and aqueous humor (AqH) outflow were measured in WT and GC-1α subunit null (GC-1-/-) mice. Mice breathed 40 parts per million (ppm) NO in O2 or control gas (N2/O2)...
September 1, 2017: Investigative Ophthalmology & Visual Science
https://www.readbyqxmd.com/read/28967593/measurement-of-cerebrovascular-reactivity-as-blood-oxygen-level-dependent-magnetic-resonance-imaging-signal-response-to-a-hypercapnic-stimulus-in-mechanically-ventilated-patients
#20
Lashmi Venkatraghavan, Julien Poublanc, Jay S Han, Olivia Sobczyk, Casey Rozen, Kevin Sam, James Duffin, David J Mikulis, Joseph A Fisher
BACKGROUND: Impaired cerebrovascular reactivity (CVR) is an important prognostic marker of stroke. Most measures of CVR lack (1) a reproducible vasoactive stimulus and (2) a high time and spatial resolution measure of cerebral blood flow (CBF), particularly for mechanically ventilated patients. The aim of our study was to investigate the feasibility of measuring CVR using sequential gas delivery circuit and gas blender for precise targeting of end-tidal PCO2 (PetCO2), and blood oxygen level-dependent magnetic resonance imaging (BOLD-MRI) signal as a surrogate of CBF, in mechanically ventilated patients...
September 26, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
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