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- Enekvist, Bruno, et al.
(författare)
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The effect of increased apparatus dead space and tidal volumes on carbon dioxide elimination and oxygen saturations in a low-flow anesthesia system.
- 2008
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Ingår i: Journal of Clinical Anesthesia. - : Elsevier BV. - 1873-4529 .- 0952-8180. ; 20:3, s. 170-174
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Tidskriftsartikel (refereegranskat)abstract
- STUDY OBJECTIVE: To determine if a large tidal volume (V(T)), with an unchanged end-tidal carbon dioxide partial pressure (P(ET)co(2)), could improve arterial carbon dioxide elimination, oxygen saturation (Spo(2)), and arterial blood oxygenation. DESIGN: Prospective, randomized, clinical study. SETTING: Single university hospital. PATIENTS: 60 ASA physical status I and II patients scheduled for elective urologic or general surgery. INTERVENTIONS: Patients were randomly assigned to one of two treatments: patients in group 1, nondead space (NDS), received a fresh gas flow of 1 L/min without added apparatus dead space volume. Patients in group 2, dead space (DS), received ventilation using an added dead space volume between the Y-piece and tracheal tube. In both groups, patients' lungs were ventilated to a fixed P(ET)co(2) value of 33.8 mmHg. Patients in the DS group were ventilated with V(T)s to maintain an airway plateau pressure (P(plateau)) of 0.04 cm H(2)O/kg over initial plateau pressure. The corrugated tube was then adjusted to maintain a fixed P(ET)co(2). MEASUREMENTS: Dead space volumes, P(ET)co(2), arterial CO(2) tension (Paco(2)), SpO(2), arterial O(2) tension (Pao(2)), V(T)s, and airway pressures were measured. MAIN RESULTS: Arterial CO(2) tension was significantly lower in the DS group, 36 +/- 2.3 mmHg, compared with the NDS group, 37.5 +/- 2.3 mmHg (P < 0.05), and the difference between P(ET)co(2) and Paco(2) was lower in the DS group than in the NDS group (P < 0.001). Oxygen saturation was 99% +/- 1.0% in the DS group compared with 98.5% +/- 1.5% in the NDS group (P < 0.05). Arterial O(2) tension was 13.2 +/- 25.5 mmHg in the DS group and 119.1 +/- 30.2 mmHg in NDS group (not significant). CONCLUSION: Larger V(T)s, with an unchanged P(ET)CO(2) concentration created by an added apparatus dead space volume, improved arterial carbon dioxide elimination.
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- Frković, Vedran, et al.
(författare)
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Finger width as a measure of femoral block puncture site : an ultrasonographic anatomical-anthropometric study
- 2015
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Ingår i: Journal of clinical anesthesia. - : Elsevier BV. - 0952-8180 .- 1873-4529. ; 27:7, s. 553-557
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Tidskriftsartikel (refereegranskat)abstract
- Study objective: Femoral nerve blockade is a regional anesthetic procedure that may be used in prehospital and emergency settings in cases of femoral trauma. Its speed and performance depend on how well the puncture site can be accurately located, something that usually is achieved via visible landmarks and/or by combining various universal preestablished measurements. Most of these methods have been derived from cadaver studies, which often suffer limitations in clinical settings. To facilitate a quick and easy determination of the puncture site, we here attempt to find an in vivo anthropometric measure that closely corresponds to the distance between the femoral artery and femoral nerve.Design: This is a prospective observational study.Patients: The study includes 67 patients presenting for elective surgery.Measurements: The distance from the femoral nerve to the femoral artery, projected to the skin, was measured by a 13-MHz ultrasonographic linear probe. Anthropometric measurements of the width of the hand fingers were carried out at the distal interphalangeal joints.Results: The distance from the femoral artery to the femoral nerve projected to the skin was found to closely correspond to the width of the fifth finger of the dominant hand measured at the distal interphalangeal joint.Conclusion: Because it relies on individual anthropometric information, this finding offers an individualized approach to determining the puncture site in a given patient. We believe that such an approach can improve and simplify femoral nerve blockade procedures in prehospital and emergency settings.
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- Schmidt, Annette, 1956, et al.
(författare)
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Is cell salvage safe in liver resection? A pilot study.
- 2009
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Ingår i: Journal of clinical anesthesia. - : Elsevier BV. - 1873-4529 .- 0952-8180. ; 21:8, s. 579-84
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Tidskriftsartikel (refereegranskat)abstract
- To investigate the quality of cell salvaged (CS) blood in patients undergoing hemihepatectomy (study group) and compare it with CS-blood from aortic surgery (control group).
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