AANA journal
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Comparative Study
Preoxygenation of patients for coronary artery bypass grafting: vital capacity versus tidal breathing.
Arterial oxygenation, as measured by serial arterial blood gases (ABGs) and in vivo polarographic PaO2 during the rapid sequence induction of general endotracheal anesthesia, was evaluated in 20 ASA physical class IV subjects undergoing elective coronary artery bypass grafting (CABG). Subjects received a narcotic premedication 30-60 minutes prior to arrival in the operating room. Subjects in Group I (n = 10) were preoxygenated with 3 minutes of tidal breathing, while Group II (n = 10) subjects took four vital capacity breaths (VCB) within 30 seconds. ⋯ After tracheal intubation, the mean PaO2 fell to 275.70 mmHg in Group I compared with 277.20 mmHg in Group II. There was no significant difference (p greater than 0.05) between the two methods of preoxygenation in their ability to increase arterial oxygen. In conclusion, vital capacity breathing is as effective as 3 minutes of tidal breathing in elevating the PaO2 in subjects with significant coronary artery disease prior to a rapid sequence induction.
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Herpetic whitlow is a herpes infection of the digits of the hand, first described in 1909, caused by either herpes simplex virus type 1 or type 2. It was not until 1959 that herpetic whitlow was reported to occur in health care professionals. Nurse anesthetists are among the many health care professionals considered to be at high risk for acquiring herpetic whitlow, making it an occupational, but preventable, disease. ⋯ Diagnosis can be made clinically and confirmed by many laboratory tests. Early recognition is most important, and treatment is symptomatic. The drug acyclovir has proven to be an effective chemotherapeutic agent for suppressive therapy.