Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Apr 1997
Clinical Trial Controlled Clinical TrialInhaled nitric oxide (40 ppm) during one-lung ventilation, in the lateral decubitus position, does not decrease pulmonary vascular resistance or improve oxygenation in normal patients.
To determine the effects of inhaled nitric oxide (NO) on venous admixture (Qs/Qt), mean pulmonary artery pressure (MPAP), and pulmonary vascular resistance (PVR) in patients undergoing one-lung ventilation (1LV) in the lateral decubitus position. ⋯ Inhaled NO at 40 ppm, during 1LV in the lateral decubitus position, did not significantly decrease MPAP in patients with normal baseline PVR. Oxygenation and Qs/Qt did not change in this setting because MPAP was not altered. At present, interventions other than administration of inhaled NO should be applied to patients with normal PVR who experience hypoxia during one-lung ventilation.
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J. Cardiothorac. Vasc. Anesth. · Apr 1997
A guide to preventing deep insertion of the cannulation needle during catheterization of the internal jugular vein.
Accidental puncture of the vertebral artery during the internal jugular vein cannulation produces lethal sequelae. To prevent this, the cannulation needle must not be inserted too deeply. However, there is no useful guide for the optimal length of insertion of the needle for accessing the internal jugular vein. The authors examined the length of the needle needed to reach the internal jugular vein with three different sizes of needle (16, 20, and 23 gauge). ⋯ The results may be a useful guide to prevent too deep insertion of the needle during internal jugular vein catheterization, especially when teaching residents who have limited experience with internal jugular vein catheterization.
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J. Cardiothorac. Vasc. Anesth. · Apr 1997
Somatosensory evoked potential monitoring during cardiac surgery: an examination of brachial plexus dysfunction.
To observe the effects of the Favoloro and sternal retractors on the ulnar and median nerve somatosensory evoked potentials (SSEPs) and to identify any relationship with postoperative brachial plexus injury. ⋯ SSEP changes correlate with the use of the sternal retractor but not the Favoloro retractor. It was not possible to replicate the results of previous investigators in predicting postoperative neurological deficits based on the SSEP changes, and therefore the routine application of SSEP as a monitor cannot be recommended on the basis on these data.