Anaesthesia and intensive care
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Anaesth Intensive Care · Apr 2004
Comparative StudyThe type of carbon dioxide absorbent has no relation to the concentration of carbon monoxide in the breathing circuit during low-flow isoflurane anaesthesia in smoking and non-smoking subjects.
The present study was designed to investigate the concentrations of carbon monoxide (CO) in the anaesthetic circuit and of arterial carboxyhaemoglobin (COHb) during low-flow isoflurane anaesthesia in smoking and non-smoking subjects using three kinds of cardon dioxide (CO2) absorbent. Thirty smoking and 30 non-smoking subjects were selected for this study, and these two groups were each divided into three groups according to the type of CO2 absorbent used (Wakolime A, Drägersorb Free, and Amsorb). Anaesthesia was maintained with 1.0% isoflurane and nitrous oxide (1. 0 l min(-1))/oxygen (1.0 l min(-1)). ⋯ There was a significant linear correlation between the concentrations of CO and COHb (r=0.86, n =30, P<0.001). In the non-smoking groups all of the parameters remained constant at low levels that were independent of the type of CO2 absorbents tested. The major source for increased intraoperative CO exposure is related to the patient's smoking status, and the type of CO2 absorbent used has no relation to an increase in CO concentration in the breathing circuit.
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Anaesth Intensive Care · Apr 2004
Comparative StudyComparison of propofol consumption and recovery time in Caucasians from Italy, with Chinese, Malays and Indians from Malaysia.
Differences in sensitivity to anaesthetic drugs may exist among different ethnic groups. Allelic variants for drug metabolizing isoenzymes and pharmacokinetic differences may account for a variable response to some anaesthetic drugs. This study was designed to compare propofol consumption and recovery characteristics in four ethnic groups: Chinese, Malays, and Indians in Malaysia and Caucasians in Italy. ⋯ The recovery of Indians was much slower compared to Chinese, Malays and Caucasians. The recovery time of Malays is significantly slower compared to Chinese and Caucasians. Differences in propofol consumption and recovery time were not significant between Chinese and Caucasians, but the ratio recovery time/propofol consumption was significantly lower in Caucasians compared to all the other groups.
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Anaesth Intensive Care · Apr 2004
The effect of haemodilution on antithrombin concentration during cardiac surgery.
The effect of haemodilution on antithrombin concentration was investigated in 73 patients undergoing elective cardiac surgery with and without cardiopulmonary bypass. In patients who required cardiopulmonary bypass (n = 45), the antithrombin concentration fell to 52% of baseline during surgery (24.2 mg.dl(-1) to 12.6 mg.dl(-1)), and the haemoglobin level fell to 55% (136 g.l(-1) to 75 g.l(-1)). ⋯ The results indicate that most of the decrease in concentration of antithrombin during cardiac surgery is a consequence of cardiopulmonary bypass and is due to haemodilution. This data demonstrates that the percentage decrease in haemoglobin concentration can be used to estimate the percentage decrease in antithrombin concentration that occurs during cardiac surgery, if blood products that might effect the results are not administered between measurements.
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Anaesth Intensive Care · Apr 2004
Case ReportsAirway problems related to laryngeal mask airway use associated with an undiagnosed epiglottic cyst.
This report describes airway management difficulties in a patient with an asymptomatic and undiagnosed epiglottic cyst. Mask ventilation after induction of general anesthesia was uneventful. ⋯ Fibreoptic intubation, assisted by the use of a direct laryngoscope without the LMA was uneventful. Preoperative craniocervical scans performed for assessment of other conditions may reveal asymptomatic pathology in the airway.
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Anaesth Intensive Care · Apr 2004
Review Case ReportsFatal systemic air embolism during endoscopic retrograde cholangio-pancreatography.
Air embolism is a rare complication of gastrointestinal endoscopy. We present a 56-year-old male who developed both venous and systemic arterial air embolism during an endoscopic retrograde cholangiopancreatogram. ⋯ Clinical diagnosis of air embolism during endoscopy is difficult and urgent echocardiography is the investigation of choice. Treatment is largely supportive but hyperbaric oxygen therapy should be considered in any severe cases, especially if neurological injury is present.