Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Aug 1996
Comparative StudyA comparison of the endobronchial segment of modern left-sided double-lumen tubes in anesthesia for bilateral sequential lung transplantation.
To compare a range of currently available left-sided double-lumen endotracheal tubes (DLTs) in order to demonstrate differences among them with respect to the length of the endobronchial segment. It is proposed that a tube with a short endobronchial segment is better suited to anesthesia under the conditions imposed by double sequential lung transplantation. ⋯ There exists marked variability in the length of the endobronchial segment of left-sided double-lumen tubes currently available. These differences may be significant in anesthesia for bilateral sequential lung transplantation.
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J. Cardiothorac. Vasc. Anesth. · Aug 1996
Positive end-expiratory pressure during one-lung ventilation improves oxygenation in patients with low arterial oxygen tensions.
The application of 10 cm H2O of positive end-expiratory pressure (PEEP10) to the ventilated lung during one-lung ventilation (OLV) has an unpredictable effect on PaO2. It was hypothesized that patients with a low PaO2 (< 80 mmHg) during OLV may benefit from application of PEEP. ⋯ In patients with a low PaO2 (< 80 mmHg) during OLV with F1O2 = 0.5, PaO2 is increased by the application of PEEP10. This maneuver may be useful in situations in which application of continuous positive airway pressure (CPAP) to the nonventilated lung is not possible.
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J. Cardiothorac. Vasc. Anesth. · Aug 1996
Randomized Controlled Trial Clinical TrialChanges in heart rate variability during induction of anesthesia with fentanyl and midazolam.
The study was designed to evaluate changes in autonomic nervous system function during induction of anesthesia with fentanyl, midazolam, and pancuronium and to answer the question of dose-dependency of these effects. ⋯ Parameters of HRV suggest that induction with fentanyl, midazolam, and pancuronium decreases sympathetic but not parasympathetic autonomic system activity. The anesthetic induction technique's modulation of autonomic nervous system balance is better represented by means of spectral analysis than by analysis in the time domain. This modulation was largely independent of the doses administered and independent of the speed of injection.
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J. Cardiothorac. Vasc. Anesth. · Aug 1996
Hyperglycemia during hypothermic cardiopulmonary bypass does not alter postbypass vascular endothelial responses in dogs.
Hyperglycemia during hypothermic cardiopulmonary bypass (CPB) may alter intrinsic vasomotion by reducing endothelial-dependent vasorelaxation. Using a canine model of hypothermic CPB, this study tested whether hyperglycemia altered the vasodilator response to acetylcholine (ACh) and the vasoconstrictor response to phenylephrine (Phe). ⋯ The reduction in ACh-mediated vasorelaxation after CPB did not differ between hyperglycemic and normoglycemic animals, indicating that hyperglycemia does not contribute to impaired vasorelaxation after CPB. Because Phe-induced vasoconstriction was unaffected, hyperglycemia during hypothermic CPB does not appear to increase the potential for postbypass vasospasm.