Anesthesia and analgesia
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Anesthesia and analgesia · Nov 2005
Air detection performance of the level 1 H-1200 fluid and blood warmer.
We evaluated the Level 1 H-1200 fluid warmer during simulated conditions of minor to massive air embolism. The fluids we tested were crystalloid and diluted red cells (estimated hematocrit 50%) during gravity and pressure driven flow. The air volumes tested ranged from 1-60 mL for crystalloid and 30-150 mL for red cells. ⋯ The device consistently alarmed and automatically shut off flow. Air was easily purged through the gas vent-filter assembly during simulated air embolism with crystalloid but not with red cell infusion. The use of ultrasonic air detection coupled with automatic shutoff is a significant safety improvement of the Level 1 H-1200 fluid and blood warmer.
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Anesthesia and analgesia · Nov 2005
Case ReportsEpidural blood patch for headache after lumboperitoneal shunt placement.
Headaches complicating lumboperitoneal (LP) shunt placement have been attributed to shunt failure with resultant high intracranial pressure or to overdrainage with resultant low intracranial pressure. In this case, a 17-yr-old girl had symptoms of a low-pressure headache after LP shunt placement alleviated by an epidural blood patch. The success of this therapy suggests postdural puncture as a possible cause for low-pressure headache after LP shunt placement. Epidural blood patch may be an alternative initial therapy for some low-pressure headaches after LP shunt placement.
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Anesthesia and analgesia · Nov 2005
Comparative StudyA comparison of the laryngeal tube and bag-valve mask ventilation by emergency medical technicians: a feasibility study in anesthetized patients.
Airway management is of major importance in emergency care. The basic technique for all health care providers is bag-valve mask (BVM) ventilation, which requires skill and may be difficult to perform. Endotracheal intubation, which is the advanced method for securing the airway, is a demanding technique that has been shown to be associated with infrequent success, even when used by experienced paramedical personnel. ⋯ Those who inserted the LT on the first attempt (73%) required 48.2 +/- 14.7 s for the insertion. Both the LT and BVM provided adequate oxygenation and ventilation. In this study, we found that inexperienced fire-EMT students inserted LT and performed 1-min ventilation with a reasonable success rate and insertion time in anesthetized patients.
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Anesthesia and analgesia · Nov 2005
Case ReportsDelayed respiratory depression after risperidone overdose.
Risperidone is an atypical antipsychotic drug used for the treatment of schizophrenia. Both positive and negative symptoms are prominent with its use. Metabolism occurs mainly in the liver, where risperidone is changed by CUP2D6 to an active metabolite, 9-hydroxyrisperidone. ⋯ Genetic polymorphism is seen in the 6%-8% of white patients who are considered poor metabolizers. In poor metabolizers, the half-life extends to 20-30 h. We present an unusual case of unanticipated delayed respiratory depression after risperidone overdose.
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Anesthesia and analgesia · Nov 2005
A rat model for isolated bilateral lung contusion from blunt chest trauma.
Lung contusion affects 17%-25% of adult blunt trauma patients, and is the leading cause of death from blunt thoracic injury. A small animal model for isolated bilateral lung contusion has not been developed. We induced lung contusion in anesthetized rats by dropping a 0.3-kg weight onto a precordial protective shield to direct the impact force away from the heart and toward the lungs. ⋯ Hypoxemia in rats with maximal sublethal injury (2.45 J) met criteria for acute lung injury at < or =24 h, improving by 48 h. BAL albumin levels were highest at < or =24 h, and remained elevated along with increased BAL leukocytes and decreased lung volumes at 48 h. We concluded that an impact energy of 2.45 J induces isolated, bilateral lung contusion and provides a useful model for future mechanistic pathophysiological assessments.