Journal of clinical monitoring and computing
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Traditionally, the study of CO2 and O2 kinetics in the body has been mostly confined to equilibrium conditions. However, the peri-anesthesia period and the critical care arena often involve conditions of non-steady state. ⋯ The lesser known area of non-steady state O2 kinetics is introduced, including the measurement of pulmonary O2 uptake per breath. Future directions include the study of the respiratory quotient per breath, where the anaerobic threshold during anesthesia is identified by increasing respiratory quotient.
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J Clin Monit Comput · Jan 2000
Randomized Controlled Trial Clinical TrialThe relationship between rate of administration of an intubating dose of rocuronium and time to 50% and 90% block at the adductor pollicis muscle.
To determine the relationship between the rate of rocuronium injection and the onset time of neuromuscular block. ⋯ We conclude that rate of injection influences only the initial phase of development of the block and that slower injection times do not significantly affect time to 90% relaxation at the adductor pollicis muscle.
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J Clin Monit Comput · Jan 2000
Comparative Study Clinical TrialNon-invasive estimation of cardiac output in critical care patients.
This study was carried out to compare cardiac output measurements determined by thermodilution and by Portapres, a non-invasive system. ⋯ To date, Portapres measurements cannot replace thermodilution cardiac output estimations. Fluctuations of finger arterial perfusion due to hemodynamic instability, hypothermia and catecholamines may be responsible for problems of Portapres use in critically ill patients.
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J Clin Monit Comput · Jan 2000
ReviewEffects of high thoracic epidural anesthesia and local anesthetics on bronchial hyperreactivity.
Bronchial hyperreactivity can cause life threatening bronchospasm after airway irritation. Therefore, endotracheal intubation is avoided in asthmatics when feasible. High thoracic epidural anesthesia can be used to avoid endotracheal intubation and offers less postoperative pulmonary complications when compared to systemic postoperative analgesia. ⋯ The attenuation of bronchial hyperreactivity can be shown as a dose dependent effect of lidocaine and bupivacaine. The intravenous effect of lidocaine is comparable to the effect of a moderate dose of salbutamol and leads to an additive effect when both drugs are used in combination. Overall, high thoracic epidural anesthesia can be used safely in patients with bronchial hyperreactivity and intravenous administration of lidocaine (1.5-2.0 mg x kg(-1)) can be used as a prophylactic treatment prior to airway instrumentation.
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Inhaled nitric oxide is a ubiquitous molecule which is produced endogenously and is also found in air pollution and in cigarette smoke. After describing the chemistry of NO, we review its history from the first description in 1980 to the current clinical indications. ⋯ Possible drug interactions are listed. Inhaled nitric oxide is here to stay, and future studies will provide more information on its therapeutic dose, duration and potential toxicity.