British journal of anaesthesia
-
Exhaled nitric oxide (NO) may reflect NO production and consumption but the pulmonary origin of NO in exhaled gas is not clear. There are also conflicting data on exhaled NO after cardiopulmonary bypass (CPB). Because intravenous nitrovasodilators increase exhaled NO by conversion to NO in the lung, we measured basal and nitroglycerin (GTN)-induced exhaled NO in patients having low-risk coronary artery bypass graft (CABG) operations using routine CPB. We reasoned that GTN-induced exhaled NO would be a primarily vascular mechanism, which would contrast with the airway epithelial origin of basal exhaled NO, and that they might be differentially influenced by CPB. ⋯ The capacity of the lungs to increase exhaled NO in response to intravenous GTN is reduced after CPB, suggesting microvascular injury and/or atelectasis after routine open-heart surgery.
-
The role of nitrous oxide in modern anaesthesia is questioned. The routine use of nitrous oxide was almost completely stopped in our department after November 1, 2000, and we now report some consequences. ⋯ The staff questionnaire showed a strong acceptance of the new policy, and the use of other anaesthetic agents did not increase as expected. Has the value of nitrous oxide been overestimated?
-
Comment Letter Case Reports
Epidural abscess complicating insertion of epidural catheters.
-
This study was designed to determine if a new point-of-care test (PFA-100) platelet function analyser) that assesses platelet function predicts blood loss after cardiac surgery. ⋯ The PFA-100 is a logical test for detecting patients who could have excessive bleeding after CPB. However, the PFA-100 was not able to separate patients at low risk of subsequent bleeding from those who had substantial bleeding.