Journal of anesthesia
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Journal of anesthesia · Feb 2011
Prompt prediction of successful defibrillation from 1-s ventricular fibrillation waveform in patients with out-of-hospital sudden cardiac arrest.
Ventricular fibrillation (VF) is a common cardiac arrest rhythm that can be terminated by electrical defibrillation. During cardiopulmonary resuscitation, there is a strong need for a prompt and reliable predictor of successful defibrillation because myocardial damage can result from repeated futile defibrillation attempts. Continuous wavelet transform (CWT) provides excellent time and frequency resolution of signals. The purpose of this study was to evaluate whether features based on CWT could predict successful defibrillation. ⋯ Energy spectrum analysis based on CWT as short as a 1.0-s VF ECG waveform enables prompt and reliable prediction of successful defibrillation.
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Journal of anesthesia · Feb 2011
Case ReportsUpper airway obstruction associated with flexed cervical position after posterior occipitocervical fusion.
Upper airway obstruction resulting from overflexion fixation of the cervical spine is a rare but life-threatening complication after cervical spine surgery. There are few reports of dyspnea after a posterior cervical fusion. We present the case of a 63-year-old woman with rheumatoid arthritis who developed an upper airway obstruction immediately after an O-C4 fusion. ⋯ Revision surgery allowing the angle to return to the neutral position was performed to ameliorate the overflexion of the cervical spine fixation and the consequent upper airway obstruction. After revision surgery, the upper airway obstruction disappeared. Our experience suggests that intraoperative use of fluoroscopy and extubation with a tube exchanger are recommended to avoid this complication, especially in patients at high risk of upper airway obstruction.
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Journal of anesthesia · Feb 2011
Preoperative depression is a risk factor for postoperative short-term and long-term cognitive dysfunction in patients with diabetes mellitus.
To identify whether the presence of preoperative depression in patients with diabetes mellitus is a risk factor for postoperative cognitive dysfunction after coronary artery bypass graft (CABG) surgery. ⋯ We found that the presence of depression preoperatively is associated with short-term and long-term postoperative cognitive dysfunction in patients with diabetes mellitus.