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Anesthesia Ventilation

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https://www.readbyqxmd.com/read/29243798/effects-of-propofol-or-sevoflurane-anesthesia-on-the-perioperative-inflammatory-response-pulmonary-function-and-cognitive-function-in-patients-receiving-lung-cancer-resection
#1
H-T Tian, X-H Duan, Y-F Yang, Y Wang, Q-L Bai, X Zhang
OBJECTIVE: To investigate the effects of propofol and sevoflurane anesthesia on the inflammatory response, pulmonary function and cognitive function of patients undergoing lung cancer resection and their differences. PATIENTS AND METHODS: 62 patients with lung cancer who underwent pulmonary lobectomy from January 2014 to January 2016 in Jining First People's Hospital were selected and randomly divided into two groups: the propofol group (n=31) and the sevoflurane group (n=31)...
December 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/29239956/the-anesthesia-workstation-quo-vadis
#2
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/29239457/opioids-and-immunosupression-in-oncological-postoperative-patients
#3
José Luis Bonilla-García, Manuel Cortiñas-Sáenz, Esperanza Del Pozo-Gavilán
INTRODUCTION: Recent animal studies demonstrated immunosuppressive effects of opioid withdrawal resulting in a higher risk of infection. The aim of this study was to determine the impact of remifentanil discontinuation on Post-Anesthesia Care Unit (PACU)-acquired infection after a schedule of sedoanalgesia of at least 6 days. METHOD: All patients over 18 years of age with a unit admission of more than 4 days were consecutively selected. The study population was the one affected by surgical pathology of any origin where sedation was based on any hypnotic and the opioid remifentanil was used as analgesic for at least 96 hours in continuous perfusion...
September 2017: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/29225741/what-is-the-proper-ventilation-strategy-during-laparoscopic-surgery
#4
REVIEW
Youn Yi Jo, Hyun-Jeong Kwak
The main stream of intraabdominal surgery has changed from laparotomy to laparoscopy, but anesthetic care for laparoscopic surgery is challenging for clinicians, because pneumoperitoneum might aggravate respiratory mechanics and arterial oxygenation. The authors reviewed the literature regarding ventilation strategies that reduce deleterious pulmonary physiologic changes during pneumoperitoneum for laparoscopic surgery under general anesthesia and make appropriate recommendations.
December 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29225003/improving-patient-safety-during-procedural-sedation-via-respiratory-volume-monitoring-a-randomized-controlled-trial
#5
Donald M Mathews, Michael J Oberding, Eric L Simmons, Stephen E O'Donnell, Kevin R Abnet, Kathleen MacDonald
STUDY OBJECTIVE: Assess the utility of a respiratory volume monitor (RVM) to reduce the incidence of low minute ventilation events in procedural sedation. DESIGN: Randomized control trial SETTING: Endoscopy suite PATIENTS: Seventy-three total patients (ASA Physical Status 1-3) undergoing upper endoscopies were analyzed. INTERVENTION: Patients were randomized into two groups using a computer generated randomization table: Control (n=41): anesthesia provider was unable to see the screen of the RVM; RVM (n=32): anesthesia provider had access to RVM data to assist with management of the case...
December 7, 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29221974/criteria-for-postoperative-mechanical-ventilation-after-thymectomy-in-patients-with-myasthenia-gravis-a-retrospective-analysis
#6
Keerthi Chigurupati, Shrinivas Gadhinglajkar, Rupa Sreedhar, Muraleedharan Nair, Madathipat Unnikrishnan, Manjusha Pillai
OBJECTIVE: To determine the criteria for postoperative mechanical ventilation after thymectomy in patients with Myasthenia Gravis. DESIGN: Retrospective study. SETTING: Teritiary care centre. PARTICIPANTS: 77 Myasthenia gravis patients operated for thymectomy were studied. INTERVENTIONS: After obtaining clearance from Institutional ethics committee, medical records of 77 patients with MG, who were operated for thymectomy between January 2005 and December 2015 were reviewed in a retrospective manner...
June 27, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29221291/airway-stenting-in-patients-requiring-intubation-due-to-malignant-airway-stenosis-a-10-year-experience
#7
Masahide Oki, Hideo Saka, Kazumi Hori
Background: Critically ill patients with severe acute respiratory failure due to malignant airway stenosis often require emergency intubation and mechanical ventilation. Urgent intervention is necessary for the survival of such patients. The aim of this study was to determine the efficacy and outcomes of airway stenting in patients with malignant airway stenosis requiring emergency intubation. Methods: Patients with malignant airway stenosis who underwent emergency intubation prior to airway stent placement from September 2005 to September 2015 in a single center were retrospectively reviewed...
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29215365/physiologic-evaluation-of-ventilation-perfusion-mismatch-and-respiratory-mechanics-at-different-positive-end-expiratory-pressure-in-patients-undergoing-protective-one-lung-ventilation
#8
Savino Spadaro, Salvatore Grasso, Dan Stieper Karbing, Alberto Fogagnolo, Marco Contoli, Giacomo Bollini, Riccardo Ragazzi, Gilda Cinnella, Marco Verri, Narciso Giorgio Cavallesco, Stephen Edward Rees, Carlo Alberto Volta
BACKGROUND: Arterial oxygenation is often impaired during one-lung ventilation, due to both pulmonary shunt and atelectasis. The use of low tidal volume (VT) (5 ml/kg predicted body weight) in the context of a lung-protective approach exacerbates atelectasis. This study sought to determine the combined physiologic effects of positive end-expiratory pressure and low VT during one-lung ventilation. METHODS: Data from 41 patients studied during general anesthesia for thoracic surgery were collected and analyzed...
December 6, 2017: Anesthesiology
https://www.readbyqxmd.com/read/29211841/perioperative-benefit-and-outcome-of-thoracic-epidural-in-esophageal-surgery-a-clinical-review
#9
P Feltracco, A Bortolato, S Barbieri, E Michieletto, E Serra, A Ruol, S Merigliano, C Ori
Surgery for esophageal cancer is a highly stressful and painful procedure, and a significant amount of analgesics may be required to eliminate perioperative pain and blunt the stress response to surgery. Proper management of postoperative pain has invariably been shown to reduce the incidence of postoperative complications and accelerate recovery. Neuraxial analgesic techniques after major thoracic and upper abdominal surgery have long been established to reduce respiratory, cardiovascular, metabolic, inflammatory, and neurohormonal complications...
December 2, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/29208758/respiratory-volume-monitoring-reduces-hypoventilation-and-apnea-in-subjects-undergoing-procedural-sedation
#10
Robert H Nichols, Justin A Blinn, Thuan M Ho, Robert A McQuitty, Michael P Kinsky
INTRODUCTION: The use of monitored anesthesia care for endoscopic procedures increases the risk of respiratory depression, necessitating careful monitoring of patient ventilation. We examined the effectiveness of an impedance-based respiratory volume monitor (RVM) in improving the safety of patients undergoing upper and lower gastrointestinal endoscopies under total intravenous anesthesia. We hypothesized that feedback from the RVM would allow anesthesiologists to maintain adequate ventilation, which would reduce the duration of respiratory depression (ie, hypoventilation and apnea) compared to a blinded control group...
December 5, 2017: Respiratory Care
https://www.readbyqxmd.com/read/29205678/perioperative-management-of-gastrostomy-tube-placement-in-duchenne-muscular-dystrophy-adolescent-and-young-adult-patients-a-role-for-a-perioperative-surgical-home
#11
Ariane Boivin, Richard Antonelli, Navil F Sethna
BACKGROUND: In past decades, Duchenne muscular dystrophy patients have been living longer and as the disease advances, patients experience multisystemic deterioration. Older patients often require gastrostomy tube placement for nutritional support. For optimizing the perioperative care, a practice of multidisciplinary team can better anticipate, prevent, and manage possible complications and reduce the overall perioperative morbidity and mortality. AIMS: The aim of this study was to review our experience with perioperative care of adolescent and young adults with Duchenne muscular dystrophy undergoing gastrostomy by various surgical approaches in order to identify challenges and improve future perioperative care coordination to reduce morbidity...
December 5, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29200060/changing-default-ventilator-settings-on-anesthesia-machines-improves-adherence-to-lung-protective-ventilation-measures
#12
Sunny S Chiao, Douglas A Colquhoun, Bhiken I Naik, Jennie Z Ma, Edward C Nemergut, Marcel E Durieux, Randal S Blank, Katherine T Forkin
Perioperative lung-protective ventilation (LPV) can reduce perioperative pulmonary morbidity. We hypothesized that modifying default anesthesia machine ventilator settings would increase the use of intraoperative LPV. Default tidal volume settings on our anesthesia machines were decreased from 600 to 400 mL, and default positive end-expiratory pressure was increased from 0 to 5 cm H2O. This modification increased mean positive end-expiratory pressure from 3.1 to 5.0 cm H2O and decreased mean tidal volume from 8...
November 30, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29189283/effects-of-increasing-airway-pressures-on-the-pressure-of-the-endotracheal-tube-cuff-during-pelvic-laparoscopic-surgery
#13
Eric B Rosero, Esra Ozayar, Javier Eslava-Schmalbach, Abu Minhajuddin, Girish P Joshi
BACKGROUND: Tracheal tube cuff pressures exceeding the perfusion pressures of the tracheal mucosa have been associated with complications such as sore throat, tracheal mucosa ulcers, tracheal rupture, and subglottic stenosis. Despite appropriate inflation, many factors can increase the tracheal cuff pressure during mechanical ventilation. This prospective observational cohort study was designed to test the hypothesis that during a clinical model of decreasing respiratory compliance, the pressure within the endotracheal tube cuff will rise in direct relationship to increases in the airway pressures...
November 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29183321/effects-of-controlled-hypoxemia-or-hypovolemia-on-global-and-intestinal-oxygenation-and-perfusion-in-isoflurane-anesthetized-horses-receiving-an-alpha-2-agonist-infusion
#14
Klaus Hopster, Liza Wittenberg-Voges, Florian Geburek, Charlotte Hopster-Iversen, Sabine B R Kästner
BACKGROUND: Aim of this prospective experimental study was to assess effects of systemic hypoxemia and hypovolemia on global and gastrointestinal oxygenation and perfusion in anesthetized horses. Therefore, we anesthetized twelve systemically healthy warmblood horses using either xylazine or dexmedetomidine for premedication and midazolam and ketamine for induction. Anesthesia was maintained using isoflurane in oxygen with either xylazine or dexmedetomidine and horses were ventilated to normocapnia...
November 28, 2017: BMC Veterinary Research
https://www.readbyqxmd.com/read/29179755/fever-after-bronchoscopy-serum-procalcitonin-enables-early-diagnosis-of-post-interventional-bacterial-infection
#15
Klaus Hackner, Waltraud Riegler, Sabin Handzhiev, Rosemarie Bauer, Jan Veres, Manuela Speiser, Karin Meisinger, Peter Errhalt
BACKGROUND: The aim of this study was to differentiate unspecific and self-limiting fever after bronchoscopy from fever due to infection by using serum procalcitonin, C-reactive protein and neutrophil count. Furthermore, frequency of fever after bronchoscopy and procedures as possible risk factors were evaluated. METHODS: Three hundred and fourteen consecutive patients were included. All bronchoscopies were performed using jet-ventilation and general anesthesia...
November 28, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/29179689/the-optimum-sevoflurane-concentration-for-supraglottic-airway-device-blockbuster%C3%A2-insertion-with-spontaneous-breathing-in-obese-patients-a-prospective-observational-study
#16
Haixia Wang, Xue Gao, Wei Wei, Huihui Miao, Hua Meng, Ming Tian
BACKGROUND: Airway management of the obese patient presenting for surgery is more likely to be a challenging problem. Supraglottic airway device has been adopted as a bridge to connect ventilation and tracheal intubation in obese patients who would be suffered with difficult intubation. The optimum sevoflurane concentration for supraglottic airway device insertion allowing spontaneous breathing in 50% of obese patients (ED50) is not known. The purpose of this study was to determine the ED50 of sevoflurane for supraglottic airway device Blockbuster™ insertion with spontaneous breathing in obese patients requiring general anesthesia...
November 28, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/29174211/retrospective-study-of-intra-anesthetic-predictors-of-prolonged-hospitalization-increased-cost-of-care-and-mortality-for-canine-patients-at-a-veterinary-teaching-hospital
#17
Melissa D Smith, Michele Barletta, Courtni N Young, Erik H Hofmeister
OBJECTIVE: To determine the impact of intraoperative anesthetic variables on the length of hospitalization, cost of care and mortality in dogs. STUDY DESIGN: Retrospective, observational study. ANIMALS: A total of 235 dogs undergoing general anesthesia. METHODS: Medical records of dogs undergoing general anesthesia between 2007 and 2014 at the University of Georgia Veterinary Teaching Hospital were reviewed. Data collected included demographic data, American Society of Anesthesiologists (ASA) physical status, type and duration of anesthesia, hemodynamic variables, temperature, ventilation, fluid therapy and adjunctive drugs administered...
June 7, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/29174123/intraoperative-anesthetic-management-of-lung-transplantation-center-specific-practices-and-geographic-and-centers-size-differences
#18
Roland Tomasi, David Betz, Sophie Schlager, Tobias Kammerer, Dominik J Hoechter, Thomas Weig, Peter Slinger, Laura V Klotz, Bernhard Zwißler, Nandor Marczin, Vera von Dossow
OBJECTIVE: Although increasing evidence in lung transplantation (LTx) suggests that intraoperative management could influence outcomes, there are no guidelines available regarding intraoperative management of LTx. The overall goal of the study was to assess geographic and center volume-specific clinical practices in perioperative management. DESIGN: Prospective data analysis. SETTING: Online survey from a single-center university hospital...
May 17, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29171300/tubeless-total-intravenous-anesthesia-spontaneous-ventilation-for-adult-suspension-microlaryngoscopy
#19
Mi Jin Yoo, Aaron M Joffe, Tanya K Meyer
INTRODUCTION: Maintaining spontaneous ventilation (SV) under total intravenous anesthesia (TIVA) without an endotracheal tube provides uninterrupted and unobstructed surgical access for suspension microlaryngoscopy (SML). This study describes the method and outcome of adults who underwent SML under tubeless TIVA-SV. METHODS: Retrospective review of adults who underwent SML between June 2014 and September 2016 using TIVA-SV without an endotracheal tube. RESULTS: Sixty-six cases in 36 patients were included with mean age of 50...
November 1, 2017: Annals of Otology, Rhinology, and Laryngology
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
#20
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
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