Anesthesia and analgesia
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High endotracheal cuff pressures have been shown to cause high mucosal pressures and a reduction in mucosal blood flow, with the risk of mucosal ischemia. We aimed to directly measure the pressure exerted by the bronchial cuffs of double-lumen tubes (DLT) and by the cuffs of three new designs of endobronchial blocker (EBB). ⋯ A transmitted pressure <30 mm Hg has been recommended to avoid mucosal injury. Our study shows that at clinically relevant cuff volumes, the pressures exerted by the cuffs do not exceed the recommended safe limit.
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Anesthesia and analgesia · Mar 2007
Clinical TrialThe accuracy of the oxygen washout technique for functional residual capacity assessment during spontaneous breathing.
Measurement of functional residual capacity (FRC) is of considerable interest for monitoring patients with lung injury. The lack of instruments has impeded routine bedside FRC measurement. Recently, a simple automated method for FRC assessment by O2 washout has been introduced. We designed this study to evaluate the accuracy of FRC measurement using the O2 washout technique. ⋯ The bias and precision of the O2 washout technique using the LUFU system were clinically acceptable when compared with FRC-He and FRC-bp for FRC assessment in spontaneously breathing volunteers.
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In healthy patients, the narrowest diameter of the subglottic upper airway is the width of the air-column at the level of the cricoid cartilage. This diameter governs the selection of the endotracheal tube size, as excessive tube diameter may damage the tracheal mucosa leading to postextubation stridor or subglottic stenosis. Unfortunately, selecting endotracheal tube size based on height, weight, or age does not reliably lead to the proper tube. The knowledge of airway diameter, especially using a bedside noninvasive tool, could therefore be helpful in anesthesia and intensive care. ⋯ In young healthy adults, ultrasonography appeared to be a reliable tool to assess the diameter of the subglottic upper airway.
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Anesthesia and analgesia · Mar 2007
Comparative StudyPerformance of the cerebral state index during increasing levels of propofol anesthesia: a comparison with the bispectral index.
The cerebral state monitor is a new device to measure depth of anesthesia. In this study we compared the cerebral state monitor with the bispectral index (BIS) monitor during propofol anesthesia. ⋯ The overall performance of both monitors during propofol induction was similar. However, the different dynamic profiles of these monitors indicate that BIS may be a more useful index for evaluating intermediate anesthetic levels, whereas CSI may be better for evaluating deeper anesthetic levels.
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Anesthesia and analgesia · Mar 2007
Clinical TrialMinimum alveolar concentration of sevoflurane for laryngeal mask airway removal in anesthetized children.
In children, it is preferable to remove the laryngeal mask airway (LMA) when the patient is still anesthetized. We sought to determine the optimal minimum alveolar concentration of sevoflurane that would allow removal of the LMA in children without airway complications. ⋯ LMA removal may be accomplished without coughing, moving, or any other airway complication at 1.84% end-tidal sevoflurane concentration in 50% of anesthetized children.