Journal of clinical monitoring and computing
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J Clin Monit Comput · Dec 2010
Clinical TrialThe influence of basic ventilation strategies on cerebral oxygenation in anesthetized patients without vascular disease.
Optimizing cerebral oxygenation is of paramount importance in certain intraoperative situations. There is, however, a paucity of published data pertaining to changes in cerebral oxygenation seen with increases in the inspired fraction of oxygen (FIO2) or end-tidal carbon dioxide (PETCO2) in anesthetized patients without vascular disease. Here we tested the hypothesis that changes in FIO2 or PETCO2 correlate to a significant change in regional cerebral oxygenation (rSO2) in anesthetized patients without vascular disease. ⋯ Modulating oxygenation and ventilation in anesthetized patients without vascular disease leads to measurable changes in rSO2.
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J Clin Monit Comput · Dec 2010
The changes of pulmonary blood flow in non-ventilated lung during one lung ventilation.
A pulmonary artery catheter placement is necessary for intrapulmonary shunt fraction evaluation. The purpose of this study was to investigate the feasibility for detecting the changes of regional pulmonary blood flow in non-ventilated lung by transesophageal echocardiography (TEE) during one-lung ventilation (OLV). ⋯ Provides an alternative method to measure the changes of pulmonary blood flow during OLV. The percent changes of regional pulmonary blood flow decreased immediately after OLV, and decreased by 60% at 30 min OLV.
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J Clin Monit Comput · Dec 2010
Comparative StudyThe influence of gender, hand dominance, and upper extremity length on motor evoked potentials.
Motor evoked potentials (MEPs) induced through transcranial magnetic stimulation (TMS) are susceptible to several sources of variability including gender, hand dominance, and upper extremity length. Conflicting evidence on the relationship between MEPs and subject characteristics has been reported. ⋯ Variability in MEP latencies between genders was due to differences in upper extremity length. Adjusting MEP latencies to upper limb length is recommended for more accurate comparison and meaningful interpretation between subjects. Hand dominance and gender do not significantly influence motor thresholds, MEP amplitude, or CMCT.
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J Clin Monit Comput · Dec 2010
How do changes in exhaled CO₂ measure changes in cardiac output? A numerical analysis model.
In a previous study in anesthetized animals, the slope of percent decreases in exhaled CO₂ versus percent decreases in cardiac output (Q(T) inflation of vena cava balloons) was 0.73. To examine the mechanisms underlying this exhaled CO₂-Q(T) relationship, an iterative numerical analysis computer model of non-steady state CO(2) kinetics was developed. ⋯ The numerical analysis computer model helps to delineate the mechanisms underlying how decreased Q(T) resulted in decreased exhaled CO₂. The model permitted deconvolution of the effects of simultaneous variables and the interrogation of parameters that would be difficult to measure in actual experiments.
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J Clin Monit Comput · Oct 2010
Clinical TrialReversal of neuromuscular blockade by sugammadex does not affect EEG derived indices of depth of anesthesia.
According to previous studies neuromuscular blockade may affect the depth of anesthesia. One theory states that neuromuscular blockade prevents disturbing EMG signals, arousing from the muscles of the forehead, from falsely elevating bispectral index (BIS)-levels. According to the afferentation theory signals generated in muscle stretch receptors, accessing the brain through afferent nerve pathways, induce arousal. By blocking these signals neuromuscular blockade would increase depth of anesthesia. Arousal has previously been associated with neostigmine reversal. This study investigates the possible effect of sugammadex on the level of anesthesia as defined by BIS and spectral entropy levels. ⋯ Sugammadex does not affect level of anesthesia as determined by BIS or entropy levels.