Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Jan 1975
Complications to tracheostomy and long-term intubation: a follow-up study.
Hospital records of 79 patients treated with tracheostomy or long-term intubation from 1969 to 1971 were reviewed, and the 43 surviving patients were examined by laryngoscopy, x-ray and spirometry for complications subsequent to these treatments. Early complications included one tube occlusion and one case of postextubation stridor in each group, one dislocated tube, one bilateral pneumothorax, and one case of fatal innominate arterial hemorrhage in the tracheostomy group, and two cases of atelectasis in the long-term intubation group. ⋯ Late complications in surviving patients were prolonged hoarseness in six patients treated with prolonged intubation, two of whom had also had tracheostomy. Radiologically verified tracheal stenosis (40-60%), four at the stoma level and one at the cuff level, all occurred in the tracheostomy group.
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Acta Anaesthesiol Scand · Jan 1975
Anesthesia for cesarean section II: effects of the induction-delivery interval on the respiratory adaptation of the newborn in elective cesarean section.
Ten healthy mothers and their infants were studied in connection with elective cesarean section. Anesthesia was induced with 250-300 mg hexobarbitone followed by 100 mg succinylcholine for endotracheal intubation. The surgeon started the operation when the eyelid reflex disappeared, and delivered the baby as quickly as possible. ⋯ At the interviews, two mothers complained of pain during skin incision, and two of nightmares. Anesthesia with barbiturate for cesarean section with the I-D intervals studied in both groups allowed good respiratory adaptation in the infants. There is, neverless, the need for an adequate period of time between induction and the start of the operation in order to minimize the risk for maternal awareness.
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Acta Anaesthesiol Scand · Jan 1975
Effects of hypothermia and hyperthermia on brain energy metabolism.
The influence of elevated and reduced body temperatures upon the metabolic state of the brain was evaluated from the tissue concentrations of phosphocreatine (PCr) ATP, ADP and AMP and from the concentrations of glucose, lactate and pyruvate in immobilized and artificially ventilated rats anesthetized with 70% N2O. The results were compared to the results obtained in normothermic animals. ⋯ At a body temperature of 42 degrees C, the metabolic pattern in the brain agreed with a state of hypoxia at a time when there was no sign of substrate depletion. Arterial blood showed excess lactate which may indicate an inadequacy of the oxygen supply also to other tissues.
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Acta Anaesthesiol Scand · Jan 1975
Comparative StudyCardiorespiratory function during thoracic anaesthesia: a comparison of two-lung ventilation and one-lung ventilation with and without PEEP5.
Previous studies have shown that, in patients undergoing thoracic surgery, a relatively high positive end-expiratory pressure (PEEP of 10 cmH2O = PEEP10) has no beneficial effect on oxygenation during one-lung ventilation (OLV). In the present investigation, cardiorespiratory function was examined in 11 patients intubated endobronchially and undergoing thoracotomy. Comparison was made between two-lung ventilation (TLV) and OLV and between zero end-expiratory pressure and PEEP5 during OLV. ⋯ The application of PEEP5 during OLV produced no significant changes in these parameters. The findings in individual patients demonstrated the relative importance of cardiac output in determining oxygen delivery during OLV. A significant negative correlation was found between inspiratory airway pressure and cardiac index during OLV.
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Acta Anaesthesiol Scand · Jan 1975
Serum cholinesterase activity in burned patients. I: biochemical findings.
The purpose of the study was to determine the magnitude and the aetiology of alterations in serum cholinesterase activity (pseudocholinesterase) in burned patients. Sixty burned patients with an estimated area of burn between 3 and 72% of body surface were investigated. Serum cholinesterase activity, serum albumin concentration and serum bilirubin were measured at various time intervals. ⋯ Minimum levels were often reached during the first 24 h, after which time the concentration rose to reach fairly constant but decreased levels after 4 to 5 days. Apart from this initial phase, the changes in serum albumin concentration were roughly proportional to the changes in serum cholinesterase activity. The possible reasons for these findings are discussed.