Medical principles and practice : international journal of the Kuwait University, Health Science Centre
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Case Reports
Successful implantation of a permanent pacemaker through a persistent left superior vena cava.
We present a case of successful implantation of a permanent pacemaker through an unusual course of a persistent left superior vena cava (PLSVC). A young male patient presented with symptomatic bradycardia and a heart rate of 35 beats per minute. ⋯ PLSVC should be suspected whenever the catheter takes an unusual position during central venous catheterization. Most right heart catheterization procedures, including permanent pacemaker implantation, can be safely completed in spite of this anomaly.
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Clinical Trial
The relationship between end tidal carbon dioxide and arterial carbon dioxide during controlled hypotensive anaesthesia.
To prospectively assess the magnitude of changes in the arterial-to-end tidal carbon dioxide gradient [P(a-ET)CO2] as well as in the ratio of physiological dead space to tidal volume (Vdphys/Vt) during controlled hypotensive anaesthesia, and to evaluate whether or not ventilatory requirements remain unaltered during this procedure. ⋯ The decrease in ETCO2 does not reflect the changes in PaCO2. The larger decrease in ETCO2 is mainly due to the increase in the Vdphys/Vt ratio. During anaesthesia, once normocapnia is achieved with normal arterial blood pressure, there is hardly any need to change the ventilation after initiation of controlled hypotension.