Journal of anesthesia
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Journal of anesthesia · Jan 2008
Comparative StudyChanges in polymorphonuclear leukocyte elastase concentrations and hemolysis parameters in patients transfused with different blood preparations, and in the blood preparations themselves.
Massive blood transfusion induces hemolysis and increases polymorphonuclear leukocyte elastase (PMNE) concentration. The purpose of this study was to compare hemolysis and PMNE concentrations in massive blood transfusions with three different preparations. ⋯ During the storage of MAP-CRC, CPD-CRC, and WB, CPD-CRC had the greatest hemolysis and WB had the highest concentration of PMNE. Patients who received massive blood transfusion of MAP-CRC had the least hemolysis and the lowest concentration of PMNE.
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Journal of anesthesia · Jan 2008
Comparative StudyComparison of oxygen consumption calculated by Fick's principle (using a central venous catheter) and measured by indirect calorimetry.
We investigated the clinical usefulness of the Fick method using central venous oxygen saturation ScvO2 and cardiac output (CO) measured by pulse dye densitometry (PDD) for monitoring oxygen consumption VO2. This prospective clinical study was performed in 28 mechanically ventilated postoperative patients after major abdominal surgery. VO2 was determined by two methods, i.e., the Fick method and indirect calorimetry. ⋯ VO2 values determined by the Fick method were significantly lower than those measured by indirect calorimetry (110 +/- 29 vs 148 +/- 28 ml x min(-1) x m(-2); P < 0.01). Bland and Altma analysis showed that the mean bias and precision were 33 ml x min(-1) x m(-2) and 32 ml x min(-1) x m(-2), respectively. The correlation between the two measurements of VO2 was weak (r (2) = 0.145; P = 0.0038), indicating that the Fick method using PDD and ScvO2 is not clinically acceptable for the monitoring of VO2.
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Journal of anesthesia · Jan 2008
Randomized Controlled TrialThe effect of heat-moisture exchanger and closed-circuit technique on airway climate during desflurane anesthesia.
We assessed whether closed-circuit anesthesia (CCA) could provide a more favorable airway climate than semi-closed anesthesia (SCA), and we also determined the beneficial effect of heat moisture exchangers (HMEs) on the preservation of airway climate during desflurane anesthesia. ⋯ CCA was much more advantageous than SCA for maintaining the patient's airway climate during the 2-h study. The beneficial effect of HME on the airway climate should be emphasized, especially in patients undergoing general anesthesia.
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Journal of anesthesia · Jan 2008
Comparative StudyAnatomical features of the right internal jugular vein in infants and young children undergoing heart surgery for congenital disease: comparison between cyanotic and noncyanotic patients.
It has been reported that children with cyanotic heart disease have elevated systemic levels of vascular endothelial growth factor, which may be related to the development of vessels. However, it is unknown whether the anatomical features of the internal jugular vein (IJV) differ between cyanotic and noncyanotic children. In this study, we compared anatomical information about the IJV of these two groups of patients. ⋯ The anatomical features of the right IJV in infants and young children with congenital heart disease were not different in cyanotic and noncyanotic patients, except for the relationship between diameter and the demographic data. In the small patients examined in our study (72% of them were infants), the diameter of the IJV was not sufficiently enlarged by the Trendelenburg position, regardless of whether the patients were cyanotic or noncyanotic.
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Journal of anesthesia · Jan 2008
Case ReportsAdequate hypnosis at very low isoflurane concentration during craniotomy monitored by electroencephalography.
We report a patient with Parkinson's disease undergoing craniotomy for a brain tumor, who had clinically adequate hypnosis at a very low concentration of isoflurane. While the raw EEG showed low-voltage slow electrical activity, the EEG analyzer of the monitor displayed high burst suppression ratios. The role of intracranial pathology and drug therapy as possible causes of the low anesthetic requirement for adequate hypnosis are discussed. This report also draws attention to the possibility of erroneous analysis of burst suppression by EEG modules.