Masui. The Japanese journal of anesthesiology
-
We experienced an accidental case in which 5 mg of vecuronium was administered to a 5 kg infant boy, aged 2 months, incrementally for 55 minutes during general anesthesia. He received general anesthesia at the hospital where there is no anesthesiologist. After surgery the surgeon felt an unusual situation during emergence period from general anesthesia and then noticed overdose of vecuronium. ⋯ Extubation was performed safely 4 and half hours after the final administration of vecuronium. Finally, he could recover with no adverse effect. To predict the optimal dose of a non-depolarizing muscle relaxant to a pediatric patient, routine monitoring of neuromuscular block is effective and essential.
-
We investigated effects of cardiogenic oscillation on overestimation of tidal volume using a lung model, with three ventilators and two ventilatory modes. ⋯ Exhaled tidal volume is overestimated during mechanical ventilation when cardiogenic oscillation is large.
-
Randomized Controlled Trial Comparative Study Clinical Trial
[Which is more useful for central venous catheterization? A comparison between a 22 gauge metal needle (Argyle) and a 24 gauge plastic cannula with a metal needle (Insyte)].
Central venous catheterization is commonly performed by puncturing the internal jugular vein. However, placement of central venous catheters is not without risk. We compared the Argyle and the Insyte in terms of usefulness and incidence of complications during central venous catheterization. ⋯ Using the Argyle makes it a little more difficult to place the needle in the appropriate venous lumen. We conclude that central venous catheterization with the Insyte was quicker and safer than with the Argyle.
-
Neonates with 18-trisomy syndrome have various anomalies including cardiac and facial anomalies. Active treatments for them have not been recommended due to a low survival over one year which is less than 10%. However, the survival over one year in our institute between 1985 and 2003 is higher at 22%, and we had a patient with survival of over 5 years. ⋯ Tracheal intubation was difficult due to small airway and facial anomalies; cleft clip, cleft palate, and macrognathia. Conventional ventilation was ineffective for elimination of carbon dioxide and oxygenation due to pulmonary hypoplasia and intra- and extra-cardiac shunts. A high frequency ventilation improved elimination of carbon dioxide and oxygenation.
-
Aortic occlusion balloon catheter (AOBC), which occludes the descending aorta without thoracotomy, is expected to prevent further blood loss and raise blood pressure (BP). We investigated the effects of AOBC retrospectively. ⋯ In our experience, AOBC was effective for raising BP in patients in hemorrhagic shock.