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Mechanical Ventilation Anesthesia

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https://www.readbyqxmd.com/read/28627976/administration-of-rocuronium-based-on-real-body-weight-versus-fat-free-mass-in-patients-with-lymphedema
#1
Zhang Jing, Aikeremujiang Muheremu, Pengfei Liu, Xiaoyun Hu, Zhao Binjiang
Objective To compare the clinical pharmacokinetics of rocuronium when applied according to fat-free mass versus real body weight during anesthetic induction of patients with lymphedema. Methods Sixty patients with lymphedema (age, 18-60 years; American Society of Anesthesiologists physical status, I-II) undergoing elective surgery with general anesthesia were randomly divided into two groups. Rocuronium was administered based on the fat-free mass in 30 patients and real body weight in 30 patients. General anesthesia was induced with propofol and remifentanil by target-controlled infusion...
January 1, 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/28627346/-study-on-rac1-mapk-erk-pathway-mediated-mechanism-and-role-in-rats-with-ventilator-induced-lung-injury
#2
Guanghua Tao, Linghui Pan, Ren Jing, Fei Lin, Huijun Dai, Wanyun Ge
OBJECTIVE: To investigate the role of Ras-related C3 botulinum toxin substrate 1/mitogen-activated protein kinase/extracellular signal-regulated kinase (Rac1/MAPK/ERK) signal pathway in rats with ventilator induced lung injury (VILI) and its mechanism. METHODS: Thirty Sprague-Dawley (SD) rats were randomly divided into spontaneous respiration group, normal tidal volume (VT) group and high VT group with 10 rats in each group. The rats in spontaneous respiration group were kept their spontaneous breathing...
March 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28615115/circulatory-collapse-in-a-parturient-undergoing-cesarean-delivery-a-diagnostic-dilemma
#3
M M Tawfik, M E Taman, A I Tarbay, M Sayed, K A Awad
Embolic events including thromboembolism, air embolism, and amniotic fluid embolism can cause cardiovascular collapse during cesarean delivery. Differentiation between the three conditions is challenging because they share many of the initial clinical and echocardiographic findings, but an accurate, definitive diagnosis allows the administration of specific therapy that may help in saving the life of the mother and/or the fetus. We report a case of cardiovascular collapse during cesarean delivery under general anesthesia; massive pulmonary thromboembolism was suspected and unfractionated heparin was administered...
May 10, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28614863/-anesthetic-management-in-thoracic-trauma-patients
#4
Alf Kozian, Astrid Bergmann, Thomas Hachenberg, Thomas Schilling
In daily practice, management of patients with blunt thoracic trauma is challenging for the anesthetist. Injuries of airways, lungs, diaphragm, heart and large vessels are the main difficulties.Respiratory and circulatory physiology in general is affected by general anesthesia, which may result in an increased number of perioperative complications. Therefore, anesthetic management of patients with thoracic trauma needs to address different clinical topics: management of difficult airways, intrinsic effects of anesthetics and mechanical ventilation on respiratory and cardiac function, the adequate replacement of blood loss as well as type and extent of the surgical intervention...
June 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28600624/desflurane-usage-during-anesthesia-with-and-without-n2o-using-flow-i-automatic-gas-control-with-three-different-wash-in-speeds
#5
Robrecht De Medts, Rik Carette, Andre M De Wolf, Jan F A Hendrickx
AGC(®) (Automatic Gas Control) is the FLOW-i's automated low flow tool (Maquet, Solna, Sweden) that target controls the inspired O2 (FIO2) and end-expired desflurane concentration (FAdes) while (by design) exponentially decreasing fresh gas flow (FGF) during wash-in to a maintenance default FGF of 300 mL min(-1). It also offers a choice of wash-in speeds for the inhaled agents. We examined AGC performance and hypothesized that the use of lower wash-in speeds and N2O both reduce desflurane usage (Vdes). After obtaining IRB approval and patient consent, 78 ASA I-II patients undergoing abdominal surgery were randomly assigned to 1 of 6 groups (n = 13 each), depending on carrier gas (O2/air or O2/N2O) and wash-in speed (AGC speed 2, 4, or 6) of desflurane, resulting in groups air/2, air/4, air/6, N2O/2, N2O/4, and N2O/6...
June 9, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28598916/protective-lung-ventilation-and-morbidity-after-pulmonary-resection-a-propensity-score-matched-analysis
#6
David Amar, Hao Zhang, Alessia Pedoto, Dawn P Desiderio, Weiji Shi, Kay See Tan
BACKGROUND: Protective lung ventilation (PLV) during one-lung ventilation (OLV) for thoracic surgery is frequently recommended to reduce pulmonary complications. However, limited outcome data exist on whether PLV use during OLV is associated with less clinically relevant pulmonary morbidity after lung resection. METHODS: Intraoperative data were prospectively collected in 1080 patients undergoing pulmonary resection with OLV, intentional crystalloid restriction, and mechanical ventilation to maintain inspiratory peak airway pressure <30 cm H2O...
July 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28569130/meta-analysis-of-electroacupuncture-in-cardiac-anesthesia-and-intensive-care
#7
Sven Asmussen, Rene Przkora, Dirk M Maybauer, John F Fraser, Filippo Sanfilippo, Kristofer Jennings, Michael Adamzik, Marc O Maybauer
BACKGROUND: Acupuncture treatment has been employed in China for over 2500 years and it is used worldwide as analgesia in acute and chronic pain. Acupuncture is also used in general anesthesia (GA). The aim of this systematic review and meta-analysis was to assess the efficacy of electroacupuncture (EA) in addition to GA in patients undergoing cardiac surgery. METHODS: We searched 3 databases (Pubmed, Cochrane Library, and Web of Science-from 1965 until January 31, 2017) for randomized controlled trials (RCTs) including patients undergoing cardiac surgery and receiving GA alone or GA + EA...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28529003/determination-of-the-appropriate-oropharyngeal-airway-size-in-adults-assessment-using-ventilation-and-an-endoscopic-view
#8
Hyun Joo Kim, Shin Hyung Kim, Ji Young Min, Wyun Kon Park
INTRODUCTION: Size 9 and 8 airways for men and women, respectively, have been proposed as most appropriate based on endoscopy. However, a limitation of this guideline is that ventilation was not assessed. METHODS: In this retrospective review of prospectively collected data, 149 patients requiring tracheal intubation for general anesthesia were included. The adequacy for manual and pressure-controlled mechanical ventilation and views at the distal end of each airway was assessed using a fiber-optic bronchoscope with various airway sizes (7, 8, 9, 10, and 11)...
April 14, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28511794/application-of-end-tidal-carbon-dioxide-monitoring-via-distal-gas-samples-in-ventilated-neonates
#9
Ziying Jin, Maoying Yang, Ru Lin, Wenfang Huang, Jiangmei Wang, Zhiyong Hu, Qiang Shu
BACKGROUND: Previous research has suggested correlations between the end-tidal partial pressure of carbon dioxide (PETCO2) and the partial pressure of arterial carbon dioxide (PaCO2) in mechanically ventilated patients, but both the relationship between PETCO2 and PaCO2 and whether PETCO2 accurately reflects PaCO2 in neonates and infants are still controversial. This study evaluated remote sampling of PETCO2 via an epidural catheter within an endotracheal tube to determine the procedure's clinical safety and efficacy in the perioperative management of neonates...
April 12, 2017: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/28495814/automated-control-of-mechanical-ventilation-during-general-anaesthesia-study-protocol-of-a-bicentric-observational-study-avas
#10
Dirk Schädler, Georg Miestinger, Tobias Becher, Inéz Frerichs, Norbert Weiler, Christoph Hörmann
INTRODUCTION: Automated control of mechanical ventilation during general anaesthesia is not common. A novel system for automated control of most of the ventilator settings was designed and is available on an anaesthesia machine. METHODS AND ANALYSIS: The 'Automated control of mechanical ventilation during general anesthesia study' (AVAS) is an international investigator-initiated bicentric observational study designed to examine safety and efficacy of the system during general anaesthesia...
May 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28493943/open-lung-approach-versus-standard-protective-strategies-effects-on-driving-pressure-and-ventilatory-efficiency-during-anesthesia-a-pilot-randomized-controlled-trial
#11
Carlos Ferrando, Fernando Suarez-Sipmann, Gerardo Tusman, Irene León, Esther Romero, Estefania Gracia, Ana Mugarra, Blanca Arocas, Natividad Pozo, Marina Soro, Francisco J Belda
BACKGROUND: Low tidal volume (VT) during anesthesia minimizes lung injury but may be associated to a decrease in functional lung volume impairing lung mechanics and efficiency. Lung recruitment (RM) can restore lung volume but this may critically depend on the post-RM selected PEEP. This study was a randomized, two parallel arm, open study whose primary outcome was to compare the effects on driving pressure of adding a RM to low-VT ventilation, with or without an individualized post-RM PEEP in patients without known previous lung disease during anesthesia...
2017: PloS One
https://www.readbyqxmd.com/read/28486318/asking-a-better-question-development-and-evaluation-of-the-need-for-trauma-intervention-nfti-metric-as-a-novel-indicator-of-major-trauma
#12
Jacob W Roden-Foreman, Nakia R Rapier, Luanna Yelverton, Michael L Foreman
Many existing metrics, such as Injury Severity Score (ISS), cannot fully describe many trauma patients because of comorbidities. This study developed and evaluated the Need For Trauma Intervention (NFTI) metric as a novel indicator of major trauma. The NFTI metric was developed from an analysis of 2,396 trauma patients at a Level I trauma center. Six commonly recorded registry variables were found to be indicative of major trauma and comprised the NFTI criteria: receiving packed red blood cells within 4 hr; discharge from the emergency department (ED) to the operating room within 90 min; discharge from the ED to interventional radiology; discharge from the ED to the intensive care unit (ICU) with an ICU length of stay (LOS) of 3 or more days; mechanical ventilation outside of procedural anesthesia within 3 days; or death within 60 hr...
May 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/28459396/-mechanical-ventilation-leads-to-remodeling-of-diaphragma-and-soleus-in-rats
#13
Lei Shao, Zhifang Wang, Feifei Wang, Jiaru Huang, Xiaoping Zhu
OBJECTIVE: To investigate the structural response of diaphragm and soleus of the rat after mechanical ventilation (MV), and to explore the specific mechanism of the dysfunction of both muscles. METHODS: Sixteen male Sprague-Dawley (SD) rats were randomly divided into control group and MV group, with 8 rats in each group. Rats in MV group were treated with controlled ventilation and maintained anesthesia, and those in control group were only anesthetized without MV and maintained anesthesia...
January 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28454590/protective-intraoperative-ventilation-with-higher-versus-lower-levels-of-positive-end-expiratory-pressure-in-obese-patients-probese-study-protocol-for-a-randomized-controlled-trial
#14
T Bluth, R Teichmann, T Kiss, I Bobek, J Canet, G Cinnella, L De Baerdemaeker, C Gregoretti, G Hedenstierna, S N Hemmes, M Hiesmayr, M W Hollmann, S Jaber, J G Laffey, M J Licker, K Markstaller, I Matot, G Müller, G H Mills, J P Mulier, C Putensen, R Rossaint, J Schmitt, M Senturk, A Serpa Neto, P Severgnini, J Sprung, M F Vidal Melo, H Wrigge, M J Schultz, P Pelosi, M Gama de Abreu
BACKGROUND: Postoperative pulmonary complications (PPCs) increase the morbidity and mortality of surgery in obese patients. High levels of positive end-expiratory pressure (PEEP) with lung recruitment maneuvers may improve intraoperative respiratory function, but they can also compromise hemodynamics, and the effects on PPCs are uncertain. We hypothesized that intraoperative mechanical ventilation using high PEEP with periodic recruitment maneuvers, as compared with low PEEP without recruitment maneuvers, prevents PPCs in obese patients...
April 28, 2017: Trials
https://www.readbyqxmd.com/read/28451032/our-experience-in-two-cases-of-type-iv-laryngotracheoesophageal-cleft-ltec-with-a-diagnosis-of-antenatal-esophageal-atresia
#15
Kaan Sonmez, Ramazan Karabulut, Zafer Turkyilmaz, Canan Turkyilmaz, Berrin Isik, Sibel Eryilmaz, Kıvanc Seref, Ebru Ozcan, Gul Meral Hosgoren, Abdullah Can Basaklar
Laryngotracheoesophageal clefts (LTECs) are rare congenital defects that are often accompanied by additional anomalies. The major issues in the treatment of these patients are intraoperative exposure insufficiency, technical difficulty of the operation, and anesthesia problems originating from the respiratory tract. Problems originating from mechanical ventilation and respiratory tract, eating disorders and relapse of fistula are among the problems encountered following surgery. Most of the time, concomitant additional anomalies also worsen the clinical picture...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28442135/-anesthetic-management-of-late-pressure-angioedema
#16
Inês Furtado, Filipe Linda, Sílvia Pica, Marco Monteiro
BACKGROUND AND OBJECTIVES: Late pressure angioedema is a rare form of angioedema in which light pressure stimulus can lead to edema after 1-12h. This uncommon and unreported entity is especially important in patients who undergo general anesthesia, for whom the usual harmless supine position, intravenous catheter insertion, standard monitoring, airway management and ventilation can lead to life threatening consequences as the trigger is a physical stimulus. CASE REPORT: In this report, we describe a successful perioperative anesthetic management of a 30 year old patient, proposed for intra-ocular lens insertion, with a severe form of the disease with peri-oral, tongue and limb edema presentation...
April 22, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28416836/-comparison-between-flexible-laryngeal-mask-airway-and-reinforced-tracheal-tube-used-for-lumbar-vertebral-surgery-in-prone-position
#17
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/28393780/does-sleep-quality-affects-the-immediate-clinical-outcome-in-patients-undergoing-coronary-artery-bypass-grafting-a-clinico-biochemical-correlation
#18
Minati Choudhury, Anushree Gupta, Milind P Hote, Poonam Malhotra Kapoor, Sandeep Khanna, M V Kalaivani, Usha Kiran
OBJECTIVE: Poor sleep quality is emerging as high prevalence among the patients suffering from cardiometabolic disturbances. The vascular polypeptide endothelin 1 (ET-1) is involved in many of the health disorders. However, its potential involvement in patients having poor sleep quality along with cardiovascular problem is limited. The present study was formulated to conduct a prospective analysis of the relationship between ET-1 and in hospital outcome in sleep disorder patients undergoing routine coronary artery bypass grafting (CABG)...
April 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28391757/dose-finding-study-comparing-three-treatments-of-remifentanil-in-cats-anesthetized-with-isoflurane-undergoing-ovariohysterectomy
#19
Marcela L Machado, João Henrique N Soares, Maria Alice Kuster de Albuquerque Gress, Douglas Dos Santos E Castro, Kaleizu Teodoro Rosa, Phillipe Bauer de Araujo Doria, Fabio Otero Ascoli
Objectives Three infusion rates of remifentanil were used in isoflurane-anesthetized cats undergoing ovariohysterectomy. The aim of this study was to identify a dosage regimen that would provide optimal anesthetic and surgical conditions, as well as to compare cardiovascular response to surgical stimulation, postoperative analgesia, anesthetic duration and quality of recovery among the tested remifentanil infusion rates. Methods Twenty-seven client-owned, mixed-breed adult healthy female cats were randomized to receive remifentanil 0...
April 1, 2017: Journal of Feline Medicine and Surgery
https://www.readbyqxmd.com/read/28368939/application-of-the-novel-ventilation-mode-flow-controlled-expiration-flex-a-crossover-proof-of-principle-study-in-lung-healthy-patients
#20
Steffen Wirth, Sebastian Springer, Johannes Spaeth, Silke Borgmann, Ulrich Goebel, Stefan Schumann
BACKGROUND: Traditionally, mechanical ventilation is achieved via active lung inflation during inspiration and passive lung emptying during expiration. By contrast, the novel FLEX (FLow-controlled EXpiration) ventilator mode actively decreases the rate of lung emptying. We investigated whether FLEX can be used during intraoperative mechanical ventilation of lung-healthy patients. METHODS: In 30 adult patients scheduled for neurosurgical procedures, we studied respiratory system mechanics, regional ventilation, oxygenation, and hemodynamics during ventilation with and without FLEX at positive end-expiratory pressure (PEEP) of 5 and 7 cm H2O...
March 31, 2017: Anesthesia and Analgesia
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