Anaesthesia and intensive care
-
Prospective data was collected on 58 patients having neurosurgery in the sitting position in one institution. The incidence of venous air embolism was 43% (25/58), of which the majority were small or moderate in size. ⋯ There was no mortality or serious morbidity. With a proper understanding of the pathophysiology of venous air embolism and the use of sensitive monitoring, anaesthesia for sitting position neurosurgery can be provided safely.
-
Anaesth Intensive Care · Jun 2005
Biography Historical ArticleThe Marrett apparatus: is hospital anaesthetic equipment compatible with field use?
Major Rex Marrett in 1945 was commissioned to design an anaesthetic apparatus for field use to replace the Field Pattern Boyle's apparatus in use during the Second World War. His design was both elegant and avant garde and was capable of being used with all agents and circuitry then in current use. ⋯ The equipment and its later developments are described. Eventually the desire for knowing volatile agent concentrations led to its decline with production ceasing in 1976.
-
Anaesth Intensive Care · Jun 2005
Intra- and extra-pericardial lengths of the superior vena cava in vivo: implication for the positioning of central venous catheters.
To reduce the possibility of cardiac tamponade, a rare but lethal complication of central venous catheters, the tip of the central venous catheter should be located above the cephalic limit of the pericardial reflection, not only above the superior vena cava-right atrium junction. This study was performed to measure the superior vena cava lengths above and below the pericardial reflection in cardiac surgical patients. Cardiac surgical patients (n = 61; 27 male), whose age [mean +/- SD (range)] was 47 +/- 15 (15-75) years, were studied. ⋯ The averaged superior vena cava length of both sides was 60.3 +/- 9.0 (44.5-90) mm. Almost half of the superior vena cava was found to be within the pericardium and half out. This information may be helpful in deciding how far a central venous catheter should be withdrawn beyond the superior vena cava-right atrial junction during right atrial electrocardiographic guided insertion, and in the prediction of optimal central venous catheter insertion depth.
-
The C. O. N. apparatus developed in the late 1950s utilised a non-explosive mixture of cyclopropane, nitrogen and oxygen. Its development is described.