Revista española de anestesiología y reanimación
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Oxygenation, or rather denitrogenation, prior to apnea during anesthetic induction attempts to replace alveolar nitrogen with oxygen to achieve an intrapulmonary oxygen reserve that will allow apnea to be as prolonged as possible with the least possible desaturation. During apnea, the rate of arterial desaturation depends mainly on the volume of oxygen stored in the lung, on mixed venous oxygen saturation, and on the presence of intrapulmonary shunt. ⋯ The efficacy of preoxygenation can be assessed by expired oxygen fraction or by pulse oximetry. In a healthy adult, both methods described ensure sufficient oxygenation (pulse oximetry 90% to 95%) after a period of apnea lasting between 6 and 10 minutes.
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Rev Esp Anestesiol Reanim · Jun 2004
Case Reports[Refractory hypotension during anesthesia in a patient treated with angiotensin receptor blockers].
A 66-year-old woman treated with valsartan, an angiotensin II receptor blocker, and diuretics was scheduled for surgery to remove a pelvic mass. Both drugs were withdrawn 24 hours before anesthetic induction. ⋯ When hypotension developed and was refractory to fluid replacement and phenylephrine administration, terlipressin, a vasopressin receptor antagonist, was infused and outcome was favorable. Anesthetized patients treated with angiotensin II receptor blockers to control hypertension may experience hypotensive events that are refractory to standard treatment but that respond to vasopressin receptor antagonists.
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Rev Esp Anestesiol Reanim · Jun 2004
[Responsibilities of the resident in anesthesiology and postoperative care].
Among medical specialties, anesthesiology/postoperative care has one of the highest rates of malpractice claims. This article treats the responsibilities of interns and residents in anesthesiology, their supervisors, and the institutions where they practice and receive training.
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Rev Esp Anestesiol Reanim · Jun 2004
Letter Case Reports[Two cases of erythroposia related to brachial plexus blocks].