Der Anaesthesist
-
Randomized Controlled Trial Clinical Trial
[Preoperative normvolemic hemodilution in heart surgery. Pulmonary changes with the use of new technics].
Interest in preoperative hemodilution (HD) has intensified perceptibly again, because of the increasing risk of adverse reactions to donor blood. However, in coronary surgery patients the use of HD is still the subject of controversy, as it may possibly influence organ function and especially lung water content. New techniques, including membrane oxygenation, extracorporeal circulation (ECC) with only "partial" bypass due to 2-stage cannulation, and hemoconcentration with cell separators, have significantly modified patient management in the field of cardiac surgery. ⋯ Starting from comparable baseline values, EVLW was not significantly changed by hemodilution. After ECC, however, the HD-RL group showed a significant increase in lung water content (means: +2.49 ml/kg equal 42.6%), whereas this was not significantly changed in the other groups. By 5 h after ECC, the lung water content had returned to baseline values and no more differences could be observed between the groups.(ABSTRACT TRUNCATED AT 250 WORDS)
-
Randomized Controlled Trial Comparative Study Clinical Trial
[Vecuronium bromide and succinylcholine procedures in medial relaxation. A comparison of electromyography and clinical findings].
Clinical and electromyographic effects of either succinylcholine (Suc) or vecuronium bromide (VEC) were compared during induction and maintenance of neuromuscular blockade for pelvic laparoscopy. ⋯ Postoperative problems are often related to an unrecognized after effects of relaxants. Suc infusion leads to a remarkable number of phase-II blocks, whereas VEC can be antagonized promptly.
-
The aim of this study was to evaluate the agreement between arterial and pulse oximeter saturation values, especially under hypoxemic conditions, and to test the applicability of the method under routine anesthesia conditions. We studied 13 patients (12 children, 1 adult) with congenital cyanotic heart defects; 12 had a surgical correction during nonpulsatile cardiopulmonary bypass and 1 had a palliative operation. Arterial and pulse oximeter measurements were simultaneously taken and compared during induction of anesthesia, surgery, and in some cases during the postoperative period. ⋯ When the comparison was restricted to the measurements in the steady state conditions, r = 0.935 resulted. The pulse oximetry saturation values had a tendency to lie below the corresponding arterial values. The fact that the pulse oximetry values were designated with HQS or LQS was no indication of a better or worse correlation with the arterial value.(ABSTRACT TRUNCATED AT 250 WORDS)
-
Randomized Controlled Trial Clinical Trial
[Hemodynamic effects of the new phosphodiesterase inhibitor enoximone in heart surgery patients].
The new phosphodiesterase-III inhibitor (PDI) enoximone is a non-catecholamine, non-glycoside cardiotonic agent with concomitant vasodilating properties. It has proved beneficial in patients with severe chronic heart failure. The influence of enoximone i.v. on hemodynamics was investigated during cardiac surgery under various conditions. ⋯ CONCLUSION. Arterial and venous vasodilation with an increase in myocardial performance (dp/dtmax) resulting in an increase in CI were the predominant hemodynamic effects of enoximone i.v. No arrhythmogenic effects or interactions with the anesthetics used were observed in this study.
-
Case Reports
[Complications caused by a Swan-Ganz catheter. An inadvertent entrapment in the right atrium during cardiac surgery].
Insertion of a Swan-Ganz catheter for measurement of pulmonary artery and pulmonary capillary wedge pressures is common for operative management of patients with borderline left ventricular function. However, use of the catheter has associated risks. This case report illustrates the inadvertent snaring, by a suture, of a Swan-Ganz line in the right atrium and its subsequent removal transvenously during rethoracotomy.