Acta anaesthesiologica Scandinavica
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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.
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Acta Anaesthesiol Scand · Jan 1975
The effect of the short-acting barbiturate enibomal (Narcodorm) on systolic time intervals.
The systolic time intervals were studied in 16 surgical patients without heart disease between 29 and 75 years of age by a non-invasive technique before and after an induction dose of enibomal (Narcodorm). The pre-injection period/left ventricular ejection time-ratio (PEP/LVET-ratio) increased between 8 and 60% and (1/PEP-2) decreased between 3 and 50%, indicating a reduction of myocardial contractility under the influence of enibomal. Factors responsible for circulatory depression during barbiturate anaesthesia are discussed.
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Acta Anaesthesiol Scand · Jan 1975
Case ReportsBrain damage following collapse of a polyvinyl tube: elasticity and permeability of the cuff.
A 13-year-old boy undergoing tympanoplasty lasting 3 1/2 hours developed serious airway obstruction at the end of surgery leading to permanent brain damage. It appeared that the no. 7 Portex "blue line" endotracheal tube had collapsed under the cuff. This was concluded because deflation of the cuff had promptly relieved the obstruction of the airway. ⋯ During anaesthesia with 66% nitrous oxide, this gas together with carbon dioxide were found to diffuse into the cuff at steady rates of 3.69 vol % and 0.36 vol % per hour, respectively. Corresponding increases in intracuff volumes were found. It is advised that disposable tubes should be carefully inspected before use and that endotracheal cuffs should be deflated periodically during anaesthesia to avoid excessive rise in cuff pressure.