Masui. The Japanese journal of anesthesiology
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Ten mongrel dogs were divided into two groups; stellate ganglion block (SGB, n = 5) group and stellate ganglion resection (SGR, n = 5) group. Anesthesia was induced with pentobarbital 25 mg.kg-1. The animals were mechanically ventilated to maintain a constant PaCO2 (35-40 mmHg). ⋯ In SGR, CCAF, BAF and ICAF increased significantly during the experiment. But VAF showed a transitory increase immediately after the resection. The authors conclude that sympathetic ganglion block with local anesthetic should be performed repeatedly when increase of blood flow in blood vessels with strong autoregulation from the brain is anticipated.
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We experienced troubled endotracheal intubation in an adult patient with asymptomatic tracheal bronchus. The breath sounds of the right upper lobe were found to be absent right after the placement of a tracheal tube. ⋯ In a patient with this anomaly, who is otherwise healthy, a placement of a tracheal tube may cause pulmonary complications. Thus, as a diminished breath sound is found to be located at the upper right lobe after endotracheal intubation, we have to think of tracheal bronchus as one of the possible causes.
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The authors have developed an ECPB system, which can be applied quickly, safely and easily under an emergency condition requiring cardiac massage and artificial ventilation. Fundamentally, the ECPB system consists of 3 parts; a portable ECPB apparatus, a pair of percutaneous cannulae and a short circuit connecting an oxygenator with the cannulae. The ECPB apparatus is assembled with commercially available components (i.e., a centrifugal pump, a battery pack, a temperature controller, a compact membrane oxygenator with a heat exchanger, etc) and they are placed on a mobile cart. ⋯ The tip of the venous cannula is adjusted to be placed near the right atrium under fluoroscopy. Initiation of ECPB via the femoro-femoral V-A cannulae assures instant and stable supply of oxygenated blood to all of the vital organs. At the present time, nothing is more important than a quick supply of oxygenated blood to the brain to ameliorate the post-ischemic brain damage.
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We evaluated efficacy of maximum surgical blood order schedule (MSBOS) using analysis of cross-match to transfusion ratio (C/T ratio) during 1 year after applying MSBOS to operations in our operating room. The MSBOS used was based on our trial reported in 1990. ⋯ Analysis with C/T ratio was very useful to recognize the present status of preparations of blood for surgery preoperatively. MSBOS should be re-evaluated regularly because of changes of operative environment such as surgeon, operative method, preoperative condition of patients, and so on.
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An open circuit tracer gas washout method for measurement of functional residual capacity (FRC) during mechanical ventilation is described and tested. The system employed a piezo-valve for dispensing sulfur hexafluoride (SF6) gas, a fast response infrared SF6 analyzer, Servo 900-C ventilator and a computer. The piezo-valve unit delivers SF6 into the airway in proportion to instantaneous inspiratory flow so that inspiratory SF6 concentration was held constant regardless of the inspiratory flow pattern. ⋯ Comparison with helium dilution methods in 24 healthy subjects gave a regression equation: y = 0.98x + 56, r = 0.98. The mean difference of the values between the two methods was 21 +/- 142 ml (M +/- 2SD). The authors conclude that the system is quite useful in determining FRC of the patients under mechanical ventilation.