Journal of anesthesia
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Journal of anesthesia · Jan 1993
Modification of hepatic protein kinase C with phorbol myristate acetate and staurosporine alters hemodynamics in the perfused rat liver.
Activation of protein kinase C (PKC) has been implicated in the pathogenesis of endotoxicosis and severe sepsis. Since hepatic blood flow and metabolism have been known to be altered in endotoxicosis and sepsis, we studied the hemodynamic effect of PKC modulation with phorbol 12-myristate 13-acetate (PMA) and staurosporine (St) on the perfused rat liver. The liver was isolated from overnight-fasted male Sprague-Dawley rats and placed in a recirculating perfusion apparatus. ⋯ Pretreatment with St significantly attenuated the flow reduction by PMA. St significantly suppressed the flow reductions by 4 x 10(-6) M of prostaglandin E2 and D2. These results suggest that the PKC inside the liver may play an important role in the regulation of hepatic blood flow during endotoxicosis and sepsis.
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Journal of anesthesia · Jan 1993
Sustained effects of plasma norepinephrine levels on femoral-radial pressure gradient after cardiopulmonary bypass.
In order to determine the influence of the sympathetic nervous system upon the femoral-radial artery pressure gradient after cardiopulmonary bypass (CPB), we examined plasma norepinephrine levels in 34 adult male patients undergoing coronary artery bypass grafting. Cardiovascular parameters, including systolic arterial pressure, mean arterial pressure, cardiac index (CI), systemic vascular resistance index (SVRI), pulmonary artery pressure (PAP), hemoglobin (Hb) and peak dP/dt of radial and femoral artery pressures were measured after sternotomy, and immediately after the discontinuation of CPB and 90 min after CPB. Plasma norepinephrine levels were measured after sternotomy, after aortic declamping and 90 min after CPB. ⋯ Although there was no significant difference in Hb or PAP of 90 min after CPB in Groups A and B, the following values, listed in the order of A to B, were obtained; CI, 2.79 +/- 0.10 versus 3.46 +/- 0.16 l.min(-1).m(-2) (P < 0.01); mean radial artery pressure (MRP), 58.7 +/- 2.4 versus 65.1 +/- 1.8 mmHg (P < 0.05); peak dP/dt of radial artery pressure, 568 +/- 64 versus 1026 +/- 61 mmHg.sec(-1) (P < 0.001); and plasma norepinephrine concentration, 1.81 +/- 0.25 versus 0.98 +/- 0.10 ng.ml(-1) (P < 0.01), which were statistically significant. The higher femoral-radial artery pressure gradient after CPB was observed in patients with both a longer CPB time and a higher plasma norepinephrine concentration. These results suggest that a marked constriction of peripheral arteries might have produced a damped transmission of the pressure pulse to the radial artery.
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Journal of anesthesia · Jan 1993
Postoperative recovery of arterial oxygen saturation determined by pulse oximetry in pediatric patients.
Small children are physiologically subject to arterial oxygen desaturation. However, few reports have referred to the risk factors related to postanesthetic hypoxemia and the duration of hypoxemia. The purpose of this study was to clarify these two aspects. ⋯ Age, height, and weight of these 10 children were significantly different from the remaining 75, but there were no significant differences in anesthetic duration and postanesthetic awakefulness between the group with postanesthetic hypoxemia and the one without. The importance of monitoring the clinical condition of pediatric patients after general anesthesia is universally acknowledged. Monitoring with the pulse oximeter has proven very useful and shows that, unless oxygen saturation is monitored, all children should receive supplemental oxygen.
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Journal of anesthesia · Jan 1993
Report on the computer software contest at the 39th Congress of the Lapan Society of Anesthesiology.
We held another computer software contest at the 39th Congress of the JSA. The aim and procedure were similar to those for the first contest in 1991. Twenty-four softwares entered the contest; the machines are divided approximately two to one ratio between NEC PC9801 series and Macintosh. ⋯ They were given away to those who made entries for the contest. Most of these programs have been registered as free softwares at various computer networks. A plan is under way to distribute them in diskette forms.