Anesthesia and analgesia
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Anesthesia and analgesia · Dec 2014
Anesthesiologist Staffing Considerations Consequent to the Temporal Distribution of Hypoxemic Episodes in the Postanesthesia Care Unit.
Hypoxemia, as measured by pulse oximetry (SpO2), is common in postanesthesia care unit (PACU) patients. The temporal distribution of desaturation has managerial implications because treatment may necessitate the presence of an anesthesiologist. ⋯ Because most (68.8%) hypoxemic episodes in the PACU occur ≥30 minutes after admission, a time by which the anesthesia provider who transported the patient usually would no longer be present (>99% of cases), the PACU needs to be considered when anesthesiologist operating room staffing and assignment decisions are made.
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Anesthesia and analgesia · Dec 2014
Editorial Biography Historical ArticleThank you, larry saidman!
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Anesthesia and analgesia · Dec 2014
Excessive variations in the plethysmographic waveform during spontaneous ventilation: an important sign of upper airway obstruction.
The respiratory variations in the plethysmographic (PLET) waveform of the pulse oximeter during mechanical ventilation can be automatically quantified as the PLET variation index (PVI(®)). Like other dynamic variables, the PVI may provide useful information about fluid responsiveness but only when the patient is receiving fully controlled mechanical ventilation with no spontaneous breathing activity. However, a growing number of monitors that automatically measure and display the values of the PVI and other dynamic variables are being introduced into clinical practice. ⋯ In 2 of these cases, simultaneously measured values of the pulse pressure variation were high as well (19% and 34%), while the calculated pulsus paradoxus was 28 and 40 mm Hg. In 2 cases, the analog signals of impedance plethysmography and capnography persisted, despite the presence of clinically significant UAO. It is, therefore, suggested that monitoring the sPVI may be of great clinical importance in spontaneously breathing patients who are susceptible to develop UAO.