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Mechanical Ventilation Anesthesia

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https://www.readbyqxmd.com/read/29325842/use-of-dexmedetomidine-in-cardiothoracic-and-vascular-anesthesia
#1
REVIEW
Lucía Gallego-Ligorit, Marc Vives, Jorge Vallés-Torres, T Alberto Sanjuán-Villarreal, Azucena Pajares, Mario Iglesias
Dexmedetomidine is a highly selective α2-adrenergic agonist with analgesic and sedative properties. In the United States, the Food and Drug Administration approved the use of the drug for short-lasting sedation (24 h) in intensive care units (ICUs) in patients undergoing mechanical ventilation and endotracheal intubation. In October 2008, the Food and Drug Administration extended use of the drug for the sedation of nonintubated patients before and during surgical and nonsurgical procedures. In the European Union, the European Medicine Agency approved the use of dexmedetomidine in September 2011 with a single recognized indication: ICU adult patients requiring mild sedation and awakening in response to verbal stimulus...
December 2, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29297798/evaluation-of-blood-gas-values-in-anesthetized-southern-white-rhinoceros-ceratotherium-simum-ventilated-with-a-novel-demand-ventilator-in-a-zoological-park-setting
#2
Mark Jeon, Khursheed R Mama, Jeffrey R Zuba, Nadine Lamberski, James E Oosterhuis, Meredith M Clancy, Katie W Delk, Matthew E Kinney, Patrick J Morris, Francisco Olea-Popelka
Rhinoceros conservation efforts are essential to the survival of the species. One such effort is focused on using advanced reproductive technologies to produce viable northern white rhinoceros ( Ceratotherium simum cottoni) embryos for implantation into southern white rhinoceros ( Ceratotherium simum simum) surrogates. Anesthesia may be required to facilitate necessary procedures in these surrogate rhinoceros, but commonly reported side effects including hypercapnia and hypoxemia limit anesthetic recumbency time due to animal safety concerns...
December 2017: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
https://www.readbyqxmd.com/read/29284881/postoperative-chylothorax-of-unclear-etiology-in-a-patient-with-right-sided-subclavian-central-venous-catheter-placement
#3
Samie Asghar, Faisal Shamim
A young male underwent decompressive craniotomy for an intracerebral bleed. A right-sided subclavian central venous catheter was placed in the operating room after induction of anesthesia. Postoperatively, he was shifted to Intensive Care Unit (ICU) for mechanical ventilation due to low Glasgow coma scale. He had an episode of severe agitation and straining on the tracheal tube in the evening same day. On the 2nd postoperative day in ICU, his airway pressures were high, and chest X-ray revealed massive pleural effusion on right side...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29250319/patients-with-uninjured-lungs-may-also-benefit-from-lung-protective-ventilator-settings
#4
REVIEW
Roger Alencar, Vittorio D'Angelo, Rachel Carmona, Marcus J Schultz, Ary Serpa Neto
Although mechanical ventilation is a life-saving strategy in critically ill patients and an indispensable tool in patients under general anesthesia for surgery, it also acts as a double-edged sword. Indeed, ventilation is increasingly recognized as a potentially dangerous intrusion that has the potential to harm lungs, in a condition known as 'ventilator-induced lung injury' (VILI). So-called 'lung-protective' ventilator settings aiming at prevention of VILI have been shown to improve outcomes in patients with acute respiratory distress syndrome (ARDS), and, over the last few years, there has been increasing interest in possible benefit of lung-protective ventilation in patients under ventilation for reasons other than ARDS...
2017: F1000Research
https://www.readbyqxmd.com/read/29225741/what-is-the-proper-ventilation-strategy-during-laparoscopic-surgery
#5
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/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/29189283/effects-of-increasing-airway-pressures-on-the-pressure-of-the-endotracheal-tube-cuff-during-pelvic-laparoscopic-surgery
#10
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/29153297/pain-management-practice-and-guidelines-in-jordanian-pediatric-intensive-care-units
#11
Ahmad Ismail, Paula Forgeron, Viola Polomeno, Huda Gharaibeh, Denise Harrison
Limited knowledge exists of current pain management practices and supporting guidelines in Jordanian pediatric intensive care units. To determine the current pain management practices and the availability and content of practice guidelines in Jordanian pediatric intensive care units, we conducted a cross-sectional and multisite survey of four pediatric intensive care units in Jordan. A questionnaire was developed and orally administered over the phone or in person to head nurses or their nominees to capture pain management practices and the existence and content of guidelines...
November 15, 2017: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
https://www.readbyqxmd.com/read/29149877/key-bottlenecks-to-the-provision-of-safe-obstetric-anaesthesia-in-low-income-countries-a-cross-sectional-survey-of-64-hospitals-in-uganda
#12
Isabella Epiu, Agnes Wabule, Andrew Kambugu, Harriet Mayanja-Kizza, Jossy Verel Bahe Tindimwebwa, Gerald Dubowitz
BACKGROUND: Despite recent advances in surgery and anaesthesia which significantly improve safety, many health facilities in low-and middle-income countries (LMICs) remain chronically under-resourced with inability to cope effectively with serious obstetric complications (Knight et al., PLoS One 8:e63846, 2013). As a result many of these countries still have unacceptably high maternal and neonatal mortality rates. Recent data at the national referral hospitals in East Africa reported that none of the national referral hospitals met the World Federation of Societies of Anesthesiologists (WFSA) international standards required to provide safe obstetric anaesthesia (Epiu I: Challenges of Anesthesia in Low-and Middle-Income Countries...
November 17, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29118307/prevention-of-pulmonary-edema-after-minimally-invasive-cardiac-surgery-with-mini-thoracotomy-using-neutrophil-elastase-inhibitor
#13
Satoshi Yamashiro, Ryoko Arakaki, Yuya Kise, Yukio Kuniyoshi
PURPOSE: Unilateral re-expansion pulmonary edema (RPE) is a rare but one of the most critical complications that may occur after re-expansion of a collapsed lung after minimally invasive cardiac surgery (MICS) with mini-thoracotomy. METHODS: We performed a total of 40 consecutive patients with MICS by right mini-thoracotomy with single-lung ventilation between January 2013 and June 2016. We divided the patients into control group (n = 13) and neutrophil elastase inhibitor group (n = 27)...
November 8, 2017: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29109631/comparative-evaluation-of-midazolam-dexmedetomidine-and-propofol-as-intensive-care-unit-sedatives-in-postoperative-electively-ventilated-eclamptic-patients
#14
Malik Rameez Rashid, Rukhsana Najeeb, Saima Mushtaq, Rizwana Habib
Background and Aims: Eclampsia is a common hypertensive disorder of pregnancy and treatment often includes termination of pregnancy with elective postoperative mechanical ventilation. The present study was aimed to compare midazolam, propofol, and dexmedetomidine for sedation and antihypertensive requirements of such patients admitted to Intensive Care Unit (ICU) after termination of pregnancy. Material and Methods: A total of ninety eclamptic patients administered general anesthesia for the termination of pregnancy through cesarean section and who also required postoperative ventilation were taken up for the study and were randomly allocated into three groups...
July 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29089468/protective-effect-of-htk-solution-on-postoperative-pulmonary-function-in-infants-with-chd-and-pah
#15
Jindong Li, Yanhong Wu, Xudong Tian, Jiantang Wang, Mingfeng Dong, Anbiao Wang
Objective In this study, we aimed to investigate the effect of pulmonary arterial perfusion (PAP) with HTK on lung protection in infants with congenital heart disease (CHD) and pulmonary arterial hypertension (PAH) after cardiopulmonary bypass (CPB). Methods Fifty infant patients with CHD and PAH at our hospital from January 2016 to February 2017 were randomly divided into control group and HTK group. The level of IL-6, MDA and ET-1 in serum were detected using ELISA Kit. Oxygen index (OI) and respiratory index (RI) were calculated at each time point...
October 31, 2017: Bioscience Reports
https://www.readbyqxmd.com/read/29081581/xylazine-infusion-in-isoflurane-anesthetized-and-ventilated-healthy-horses-effects-on-cardiovascular-parameters-and-intestinal-perfusion
#16
Klaus Hopster, Liza Wittenberg-Voges, Sabine B R Kästner
To investigate the effects of a xylazine infusion during isoflurane anesthesia on global perfusion parameters and gastrointestinal oxygenation and microperfusion, 8 adult warmblood horses were sedated with xylazine and anesthesia induced with midazolam and ketamine. Horses were mechanically ventilated during anesthesia. After 3 h of stable isoflurane anesthesia (FEIso 1.3 Vol %), a xylazine infusion with 1 mg/kg body weight (BW) per hour was started for 1 h and then stopped. Before, during, and after xylazine infusion, heart rate (HR), arterial blood pressure (MAP), cardiac output (CO), central venous pressure (CVP), and pulmonary artery pressure (PAP) were measured and systemic vascular resistance (SVR) was calculated...
October 2017: Canadian Journal of Veterinary Research, Revue Canadienne de Recherche Vétérinaire
https://www.readbyqxmd.com/read/29072363/poor-performance-of-main-stream-capnography-in-newborn-infants-during-general-anesthesia
#17
Victoria Karlsson, Bengt Sporre, Lena Hellström-Westas, Johan Ågren
BACKGROUND: Endtidal (ET) measurement of carbon dioxide is well established for intraoperative respiratory monitoring of adults and children, but the method's accuracy for intraoperative use in small newborn infants has been less extensively investigated. AIMS: The aim of this study was to compare carbon dioxide from ET measurements with arterialized capillary blood samples in newborn infants during general anesthesia and surgery. METHODS: Endtidal carbon dioxide was continuously measured during anesthesia and surgery and compared with simultaneous blood gas analyses obtained from capillary blood samples...
October 26, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29059880/evaluation-of-indirect-measures-of-neural-inspiratory-time-from-invasive-and-noninvasive-recordings-of-respiratory-activity
#18
Daniel Garcia-Castellote, Abel Torres, Luis Estrada, Leonardo Sarlabous, Raimon Jane
Measuring diaphragmatic electromyography (EMGdi) provides an indirect quantification of neural respiratory drive and allows the delimitation of diaphragm neural activation and deactivation during inspiration. EMGdi recordings have been incorporated in novel modes of assisted mechanical ventilation, such as neurally adjusted ventilatory assist (NAVA), to trigger and cycle-off the ventilator. The EMGdi signal improves the assistance delivered by more conventional ventilatory modes, in which the ventilator is synchronized with the patient employing a pneumatic triggering...
July 2017: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/29048703/a-pilot-study-on-the-efficacy-and-safety-of-a-minimally-invasive-surgical-and-anesthetic-approach-for-ventricular-assist-device-implantation
#19
Jonida Bejko, Demetrio Pittarello, Gianclaudio Falasco, Guido Di Gregorio, Vincenzo Tarzia, Giulio Rizzoli, Dario Gregori, Gino Gerosa, Tomaso Bottio
BACKGROUND: The aim of our study was to compare 2 surgical and anesthetic approaches during ventricular assist device implantation. METHODS: 68 patients (50.4 ± 17.1 years old) were supported with the HeartWare® HVAD (32 patients) and the Jarvik 2000 VAD (36 patients) between January 2010 and August 2016. Two surgical techniques were applied: a minimally invasive approach with the aid of paravertebral-block (mini-invasive group, 41 patients) and a standard-surgical-approach with the aid of general anesthesia (27 patients)...
October 16, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/29044830/optimal-management-of-apparatus-dead-space-in-the-anesthetized-infant
#20
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
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