Anesthesia and analgesia
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Anesthesia and analgesia · Jul 2013
The effect of full expiration on the position and size of the subclavian vein in spontaneously breathing adults.
If full expiration during subclavian venous cannulation increases the distance between the subclavian vein (SCV) and the pleura or increases the diameter of the vein, it might decrease the incidence of pneumothorax and/or increase the success rate of venous cannulation. In this study, we evaluated the effect of full expiration on the distance from the SCV to the pleura and on the crosssectional area (CSA) of the SCV in spontaneously breathing adults. ⋯ The distance from the SCV to the pleura did not change after full expiration. However, this simple technique can still be considered during placement of subclavian catheters in spontaneously breathing patients, because it significantly enlarges the CSA of the SCV.
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Anesthesia and analgesia · Jul 2013
Special article: evaluation of a novel noninvasive respiration monitor providing continuous measurement of minute ventilation in ambulatory subjects in a variety of clinical scenarios.
Currently there is no technology that noninvasively measures the adequacy of ventilation in nonintubated patients. A novel, noninvasive Respiratory Volume Monitor (RVM) has been developed to continuously measure and display minute ventilation (MV), tidal volume (TV), and respiratory rate (RR) in a variety of clinical settings. We demonstrate the RVM's accuracy and precision as compared with a standard spirometer under a variety of clinically relevant breathing patterns in nonintubated subjects. ⋯ This study demonstrates RVM's clinically relevant accuracy and precision in measuring MV, TV, and RR over a 24-hour period and during various breathing patterns.
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Anesthesia and analgesia · Jul 2013
The effects of the Trendelenburg position and intrathoracic pressure on the subclavian cross-sectional area and distance from the subclavian vein to pleura in anesthetized patients.
The effects of maneuvers to increase intrathoracic pressure and of Trendelenburg position on the cross-sectional area (CSA) of the subclavian vein (SCV) and the relationship between the SCV and adjacent structures have not been investigated. ⋯ The combined application of inspiratory hold and Trendelenburg position provided a greater and more relevant degree of CSA increase without compromising DSCV-pleura, which may facilitate SCV catheterization. Further investigations are needed to determine whether these results affect the success rate of catheterization and the risk of procedural injury.
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Anesthesia and analgesia · Jul 2013
Clinical TrialThe accuracy and responsiveness of continuous noninvasive arterial pressure during rapid ventricular pacing for transcatheter aortic valve replacement.
The accuracy of measurement of the continuous noninvasive arterial blood pressure (CNAP) technique is unknown during sudden cardiocirculatory arrest. ⋯ The stand-alone CNAP monitor (model 500at, software V3.5) accurately and rapidly measures the changes of blood pressure that occur during sudden development of cardiocirculatory arrest and recovery to baseline blood pressures. CNAP monitors the duration of the arrest.