Acta anaesthesiologica Scandinavica. Supplementum
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Acta Anaesthesiol Scand Suppl · Jan 1995
Comparative Study Clinical TrialAdministration of 51W89 by infusion--a comparison with atracurium--preliminary communication.
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Acta Anaesthesiol Scand Suppl · Jan 1995
Comparative StudyCentral venous versus mixed venous oxygen content.
Mixed venous oxygen content (commonly measured as oxygen saturation) is a highly relevant parameter in the monitoring of critically ill patients; unfortunately, its measurement requires catheterization of the pulmonary artery. Though less invasive, the central venous oxygen saturation is an unsatisfactory substitute, due to fluctuations in perfusion distribution and regional oxygen extraction in the course of illness. The present study examined the relation of oxygen contents in simultaneously withdrawn central venous and mixed venous blood samples from critically ill patients, in order to validate a hypothetical algorithm for the estimation of mixed venous oxygen content from a central venous sample: Although the proposed algorithm had a fairly high power of prediction, its merits in comparison to assuming simple proportionality between central venous and mixed venous oxygen content seemed marginal. However, as it is likely that the results so far are mathematically coupled, further prospective studies are necessary.
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Acta Anaesthesiol Scand Suppl · Jan 1995
The influence of arterial carbon dioxide on cerebral oxygenation and haemodynamics during ECMO in normoxaemic and hypoxaemic piglets.
To investigate the cerebrovascular response to changes in arterial CO2 tension during extracorporeal membrane oxygenation (ECMO) in normoxaemic and hypoxaemic piglets. ⋯ Since cerebrovascular reactivity to CO2 remains intact during ECMO in piglets, it is important to keep arterial CO2 tension stable and in normal range during clinical ECMO.
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Mivacurium has been little studied in infants and children without a volatile anaesthetic agent. We analysed onset time and maximal neuromuscular response after mivacurium 0.1 mg/kg, and the infusion requirement of mivacurium to maintain a 50, 90, or 95% neuromuscular block in 76 infants and children under N2O-O2-alfentanil anaesthesia. Furthermore, we assessed the time course of potentiation of 1 MAC end-tidal halothane or isoflurane on the infusion requirement of mivacurium. ⋯ In conclusion, mivacurium is easy to administer as bolus doses or continuous infusion in paediatric patients because its potency is similar in all patients from 1 month to 15 years of age. Halothane and isoflurane produce their maximal potentiation of neuromuscular block only after 30-60 min of administration. This potentiation is similar in magnitude in all patients, but takes place fastest in the youngest children.
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Acta Anaesthesiol Scand Suppl · Jan 1995
Optimal values for oxygen transport during hypothermia in sepsis and ARDS.
Mild hypothermia (33 degrees C to 35.5 degrees C) is reported to improve oxygenation and survival in patients with lung failure (1). Although hypermetabolism may account for about 50% of the ventilatory demand in ARDS patients, the concept of reducing oxygen consumption (VO2) by lowering metabolic rate, has only recently gained attention (2). Our study was aimed to test whether mild hypothermia established by continuous veno-venous haemofiltration (CVVHF), could optimize values for oxygen kinetics in ARDS patients. ⋯ These results suggest that the inability to achieve optimal values for DO2 and VO2 during mild hypothermia induced by CVVHF could serve as a prognostic sign for fatal outcome. Although oxygen consumption is decreased during hypothermia, hypoxaemia may result due to alterations of the oxygen transport on a cellular basis. The relationship between oxygen transport and temperature during CVVHF therefore deserves further studies.