Journal of clinical anesthesia
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The utility of integrated pulse and pulmonary artery oximetry, known as dual oximetry, was evaluated by monitoring 10 critically ill surgical patients for a total of 208 patient hours. The ventilation-perfusion index (VQI), an estimate of venous admixture, and the oxygen extraction index (O2EI), an estimate of tissue oxygen utilization coefficient, previously described, were calculated on-line from arterial and mixed venous oxyhemoglobin saturations using a computer. Effective monitoring was accomplished 85% of the total time. ⋯ Dual oximetry appears to be a technically reliable and accurate method of monitoring pulmonary gas exchange and tissue oxygen utilization. The equipment provided stable readings for at least six hours without recalibration. Random variability is sufficiently small to allow early detection of alterations in pulmonary and circulatory function without blood sampling.
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Biography Historical Article
A 19th century medical gift: the Herbert Leslie Burrell Ether Prize of 1896.
The Herbert Leslie Burrell Ether Prize of 1896 was established to recognize the skill and compassion of surgical house officers who administered ether in the most humane manner. The gift was made in tribute to a prominent surgeon at Boston City Hospital and serves to acknowledge the significance of ether anesthesia as one of the pivotal factors in the development of modern surgery.
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Any drug or blood product administered in the perioperative period has the potential to produce a life-threatening allergic (immune reaction) called anaphylaxis. Anaphylactic reactions represent adverse reactions mediated by immunospecific antibodies (IgE and IgG) that interact with mast cells, basophils, or the complement system to liberate vasoactive mediators and recruit other inflammatory cells. ⋯ Rapid and timely cardiopulmonary intervention with airway maintenance, epinephrine, and volume expansion is essential to avoid an adverse outcome. Severe reactions may be protracted, especially during anesthesia, requiring even larger doses of catecholamines and intensive care observation.