Journal of cardiothoracic and vascular anesthesia
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Switching from two-lung to one-lung ventilation would be expected to have large effects on lung mechanical properties, and these effects may depend on tidal volume and respiratory frequency. These changes in lung mechanics with one-lung ventilation may be similar to pulmonary edema. Deteriorating lung mechanics during pulmonary edema have been attributed to a loss of ventilated lung units. Therefore, changes in lung mechanics caused by one-lung ventilation were measured and compared with those previously seen during pulmonary edema. ⋯ The lack of tidal volume dependence in EL and lack of large-frequency dependence in RL during one-lung ventilation are inconsistent with changes induced by severe pulmonary edema. Although decreases in ventilatable lung volume may contribute to increases in lung elastance, other characteristics of mechanical behavior during one-lung ventilation differ from those of pulmonary edema; therefore, other additional mechanisms must be involved in determining lung mechanical properties during severe pulmonary edema.
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J. Cardiothorac. Vasc. Anesth. · Aug 1997
The effects of cardiopulmonary bypass on total and unbound plasma concentrations of propofol and midazolam.
To examine the effects of cardiopulmonary bypass (CPB) on total and unbound plasma concentrations of propofol and midazolam when administered by continuous infusion during cardiac surgery. ⋯ Unbound concentrations of propofol and midazolam are not affected by cardiopulmonary bypass. Total intravenous anesthesia algorithms do not need to be changed to achieve stable unbound plasma concentrations when initiating CPB.
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J. Cardiothorac. Vasc. Anesth. · Aug 1997
The effects of endobronchial cuff inflation on double-lumen endobronchial tube movement after lateral decubitus positioning.
This study was designed to measure changes in tracheal and bronchial lumen distances from mainstem and secondary carina with lateral positioning, and to assess whether inflation of the endobronchial cuff before lateral positioning would further secure a double-lumen endobronchial tube (DLT) and reduce movement. ⋯ DLTs move with lateral positioning, regardless of endobronchial cuff inflation. The movement is predominantly in the upward direction. Therefore, fiberoptic visualization in the supine position should be used only to confirm that the endobronchial lumen is placed on the appropriate side and the cuff is at least 1 cm inside the left mainstem bronchus. Final positioning should always be verified in the lateral position.
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J. Cardiothorac. Vasc. Anesth. · Aug 1997
Comparative StudyA comparison of two different bronchial cuff designs and four different bronchial cuff inflation methods.
To compare directly measured pressures at the cuff/trachea interface that are associated with two different bronchial cuff designs and four different methods of bronchial cuff inflation suggested for use with one-lung ventilation. ⋯ To achieve lung separation with the lowest pressure on the trachea, the new test is the most appropriate method for use with the double-lumen tube; however, the negative-pressure test appeared to be the easiest and fastest method for use with the bronchial blocker. Although the bronchial blocker was associated with lower pressures transmitted from the cuff to the trachea, the in vitro model cannot predict which bronchial cuff design would be superior in vivo.
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J. Cardiothorac. Vasc. Anesth. · Aug 1997
Comparative StudyComputerized data collection in the operating room during coronary artery bypass surgery: a comparison to the hand-written anesthesia record.
To investigate variability between hand-written and computerized anesthesia records and evaluate any associated bias. ⋯ Because of the lack of explained variability between the computer system and hand-written anesthesia records and the bias in the hand-written anesthesia record, the hand-written anesthesia record should not be relied on as a source of accurate data for research purposes.