Journal of anesthesia
-
Journal of anesthesia · Jan 2004
Case ReportsConversion of atrial fibrillation to sinus rhythm during landiolol infusion.
A 71-year-old woman with a history of persistent atrial fibrillation underwent clipping of a ruptured cerebral artery aneurysm. During the surgery her cardiac rhythm was atrial fibrillation and the ventricular rate increased to 130 beats.min(-1). ⋯ Approximately 120 min after the landiolol infusion was started, the atrial fibrillation was converted to sinus rhythm. Her sinus rhythm was maintained until she left the operating room, even after discontinuation of landiolol.
-
Journal of anesthesia · Jan 2004
The volatile anesthetics halothane and isoflurane differentially modulate proinflammatory cytokine-induced p38 mitogen-activated protein kinase activation.
Volatile anesthetics affect the cardiovascular and immune systems. Toward a better understanding of the molecular mechanisms behind the modulation exerted by these agents, we focused on the effects of halothane and isoflurane on the activation of p38 mitogen-activated protein kinase (MAPK), which plays a critical role in the cellular responses to extracellular stimuli such as lipopolysaccharide (LPS) and proinflammatory cytokines, including tumor necrosis factor (TNF) and interleukin 1 (IL-1). ⋯ Our in vitro results indicate that the volatile anesthetics used in the clinical field and in animal experiments modify the p38 MAPK signaling cascade and suggest that the target molecules of the anesthetics are not unique and the anesthetics regulate them differentially at clinically relevant doses.
-
Journal of anesthesia · Jan 2004
Changes in respiratory pattern during continuous positive airway pressure in infants after cardiac surgery.
Spontaneous breathing trials are commonly used in adults to enable smooth weaning from mechanical ventilation. However, few investigations have examined spontaneous breathing tests in infants. We investigated how respiratory patterns of infants changed during continuous positive airway pressure (CPAP) and whether successful extubation followed CPAP. ⋯ After cardiac surgery, when infants recovered stable hemodynamics and spontaneous breathing, the ventilatory pattern and hemodynamics became stable after 10 min of CPAP. Ninety-two percent of the patients were successfully extubated following a 30-min CPAP trial.
-
Journal of anesthesia · Jan 2004
Effects of withdrawal of phasic lung inflation during normocapnia and hypercapnia on the swallowing reflex in humans.
This study was done to test the hypothesis that hypercapnia has a direct, inhibitory effect on swallowing. ⋯ The results of our study strongly suggest that the attenuation of the swallowing reflex during hypercapnia is not due to the direct, inhibitory effect of CO2 on the swallowing center, but, rather, is due to the increased inhibitory influence of a lung-volume-related reflex.
-
Journal of anesthesia · Jan 2004
Changes in plasma total and ionized magnesium concentrations and factors affecting magnesium concentrations during cardiac surgery.
The purpose of this study was to measure blood total and ionized magnesium concentrations ([TMg] and [Mg(2+)], respectively) and to investigate factors that might be affecting their changes during cardiac surgery using hypothermic cardiopulmonary bypass. Eight patients were examined. All the patients received diuretics and predeposited autologous blood during surgery. ⋯ Hematocrit decreased significantly from the prebypass period, and FEMg increased significantly after aortic cross-clamping. In conclusion, hemodilution and renal loss were main causes of hypomagnesemia, and citrate in predeposited autologous blood may contribute to the decrease in [Mg(2+)]/[TMg] in the postbypass period. These results suggest that magnesium supplementation under close monitoring of [Mg(2+)] should be required during cardiac surgery.