Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Jan 1987
Continuous measurement of oxygen uptake. Evaluation of the Engström metabolic computer and clinical experiences.
A new system for continuous measurement of oxygen uptake was tested. The tidal volumes delivered by the system, the accuracy of the oxygen sensor cell, measurement of the oxygen uptake at different inspired oxygen concentrations, and comparative tests of oxygen uptake using the Fick principle were studied. Judging from our results, even thorough maintenance could not entirely prevent leakages. ⋯ In comparative tests of oxygen uptake using the Fick principle (cardiac output and arteriovenous oxygen content difference), we found a mean difference between EMC and the Fick principle of about 6.6% (P less than or equal to 0.001, r = 0.91) with nearly identical standard deviations for both values. Our experience indicates that the EMC is suitable for continuous measurements of oxygen uptake. Additional technical improvements seem to be possible.
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Acta Anaesthesiol Scand · Nov 1986
Randomized Controlled Trial Clinical TrialLow-dose ketamine infusion for analgesia during postoperative ventilator treatment.
In a randomized, double-blind study with placebo, ketamine was used as an analgesic during ventilator treatment in the period of recovery after major abdominal surgery. Forty patients were orally intubated and ventilated by means of a volume-controlled ventilator. Twenty of them received an i.v. bolus of 30 mg of ketamine followed by an 8-h infusion of 1 mg per minute. ⋯ Dreams and hallucinations were recalled in three patients in the control group and five in the ketamine group. Only one control and two ketamine patients experienced these as unpleasant. In this investigation, ketamine infusion in a low dose appeared to offer satisfactory analgesia and to permit tolerance of the orotracheal tube.
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Acta Anaesthesiol Scand · Nov 1986
Work practices relating to intubation and associated procedures in intensive care units in Sweden.
A survey into the current usage of tracheal tubes and associated procedures, such as various sedation regimes and antacid therapy, in intensive care units was carried out in Sweden by sending a questionnaire to physicians in charge of intensive care units in 70 acute hospitals which included seven main teaching hospitals. The purpose of the survey was to see how far the recent advances in tube and cuff design and awareness of the problems caused by prolonged therapeutic paralysis in intensive care units have influenced the attitudes and work practices of physicians in Sweden. Forty-nine replies were received (a 70% response rate). ⋯ The majority of units rarely used muscle relaxants. Phenoperidine and diazepam were the most popular drugs used for the sedation technique. 71.4% of teaching hospitals and 40.9% of non-teaching hospitals used antacids routinely in patients on intermittent positive pressure respiration. The results are discussed.
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Acta Anaesthesiol Scand · Oct 1986
Case ReportsAsystole and bradycardia in adult patients after a single dose of suxamethonium.
Two cases of cardiac asystole and one case of severe bradycardia were seen following a single injection of suxamethonium in a series of 46 adult patients in whom anaesthesia was induced with fentanyl and etomidate. It is suggested that the vagomimetic effects of fentanyl and, possibly also of etomidate, may contribute to the enhancement of the bradycardic effects of suxamethonium.
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Acta Anaesthesiol Scand · Oct 1986
Epidural catheters of the multi-orifice type: dangers and complications.
A study on epidural catheters of the multi-orifice type, investigating their tendency to epidurovasal (with an intravascularly positioned catheter tip) and epidurosubarachnoid (with the catheter tip inserted in the subarachnoid space) malpositioning, was conducted on 113 patients using clinical and radiological criteria as controls. Of the improperly placed catheters, 13 were in an epidurovasal (11.5%) and one was in an epidurosubarachnoid (0.9%) position. ⋯ The insufficiency of controlling or even recognizing such improperly placed catheters which are only partially in the epidural space, as well as the danger of causing a secondary dural or vascular perforation with epidural catheters, is discussed. Since epidural catheters of the multi-orifice type apparently represent an inherent, vital danger due to their construction (regardless of the catheter material and workmanship), they should no longer be used.