Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Oct 1989
ReviewLung function during anesthesia and respiratory insufficiency in the postoperative period: physiological and clinical implications.
This review covers the physiological and clinical implications of lung function during anesthesia and respiratory insufficiency in the postoperative period. We have divided it into 3 main sections: 1) lung function changes induced by anesthesia and surgery, in which the impact on pulmonary mechanics, ventilation/perfusion changes and gas exchange are examined; 2) physiological implications of postoperative respiratory function secondary to decreased alveolar ventilation, development of atelectasis, and interstitial lung edema; and 3) clinical implications of postoperative respiratory failure. In this last section we analyze the current therapeutic modalities available to reduce the incidence of postoperative respiratory failure, as well as related morbidity and mortality.
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Acta Anaesthesiol Scand · Oct 1989
Comparative Study Clinical Trial Controlled Clinical TrialThiopentone pharmacokinetics during cardiopulmonary bypass with a nonpulsatile or pulsatile flow.
To evaluate possible factors affecting the pharmacokinetics of thiopentone during cardiopulmonary bypass (CPB), the present study was undertaken in patients scheduled for coronary artery bypass grafting and with in vitro experiments. The effects of nonpulsatile and pulsatile flow during CPB on the distribution and elimination of thiopentone were compared in 30 patients anaesthetized with fentanyl. The initial rapid phases of distribution of thiopentone were studied in 17 patients undergoing a nonpulsatile or pulsatile perfusion, to whom thiopentone 6 mg/kg was given as a rapid intravenous bolus during CPB. ⋯ After a 60-min circulation time, only 50% of the predicted thiopentone level was recovered from the perfusate. It is concluded that replacing a nonpulsatile perfusion with a pulsatile one has no effect on the distribution and elimination of thiopentone in patients undergoing CPB. During CPB, thiopentone is sequestered in the extracorporeal circuit but not in the lungs.