Journal of anesthesia
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Journal of anesthesia · Mar 1995
Prophylactic hemostatic drugs do not reduce hemorrhage: Thromboelastographic study during upper abdominal surgery.
Although a number of hemostatic drugs are currently used during surgery to reduce hemorrhage, their effects on bleeding are still controversial. Furthermore, few studies have been made on their prophylactic effects. The purpose of this study was to clarify the effects of hemostatic drugs on bleeding. ⋯ No significant difference in blood loss was observed between the groups. Our findings, therefore, suggest that these two hemostatic drugs do not have prophylactic effects on intraoperative bleeding. Further studies are, however, necessary before applying these results to all surgical patients.
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Journal of anesthesia · Mar 1995
Auditory brainstem responses after out-of-hospital cardiac arrest: Are they useful for outcome prediction?
We evaluated whether we could predict the neurologic outcome in 55 out-of-hospital cardiac arrest patients using auditory brainstem responses (ABR). ABR patterns were classified into one of 3 types by evaluation of 5 components: type 1, with all 5 components; type 2, lack of at least one response between the 2nd and 5th components; type 3, with only the first component or no response. The relation between the ABR patterns on the 3rd day following resuscitation and the neurologic outcome on hospital discharge was evaluated. ⋯ In the type-1 ABR patients, the negative predictive value that the patients were awake was 100%. In the type-3 ABR patients, the negative predictive value that the patients became brain dead was 90.9%. These results suggest that ABR on the 3rd post-resuscitation day may not be useful for predicting if patients are awake or become brain dead, although the loss of components may be a sign of morbidity, and the presence of the 2nd or later components indicates possible future prevention of brain death.
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Journal of anesthesia · Mar 1995
Ischemia may be less detrimental than anemia for O2 transport because of CO 2 transport: A model analysis.
We analyzed the relationship between oxygen delivery (Do2) and Pto2 (tissue Po2). We found an important factor which has not been specified before. In the previous O2 transport model, Do2 was a dependent variable, calculated from hemoglobin, blood flow, Pao2, and the oxygen dissociation curve (ODC). ⋯ In ischemia the CO2 transport is disturbed, leading a higher draining venous Pco2, which in turn maintains a higher Po2 the capillary, resulting in a higher gradient for Po2 between capillary and the tissue. Between ischemia and anemia, ischemia is less detrimental than anemia. In ischemia, the CO2 transport is disturbed, which in turn maintains a higher Po2 at the capillary.
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Journal of anesthesia · Mar 1995
RETRACTED ARTICLE: Effects of nicardipine on diaphragmatic fatigue in the dog: The relationship between dosage and fatigability.
We examined the dose-related effects of nicardipine on the diaphragmatic fatigability in 24 anesthetized, mechanically ventilated dogs. Animals were divided into three groups of eight each: the control group (group C), the nicardipine 3 μg·kg(-1) I. V. group (group N1) and the nicardipine 5 μg·kg(-1)·min(-1) I. ⋯ The speed of recovery of Pdi at 20 Hz stimulation was dose dependent. The integrated diaphragmatic electric activity (Edi) in each group did not change at any frequency of stimulation throughout the study. Our results demonstrate that nicardipine causes a dose-dependent reduction of the contractility of the fatigued diaphragm.