Kyobu geka. The Japanese journal of thoracic surgery
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In this review, the author summarizes the recent development in the anesthesia methods, anesthetics, and anesthesia-related technology including intraoperative monitors and anesthesia medical information systems. Modern anesthesia workstations have features called fresh gas decoupling systems to prevent excess inspiratory volume and pressures that may induce barotraumas or volutrauma to the patients' lungs. Compared to volatile inhalational anesthetics, intravenous anesthetics might have several advantages. ⋯ In addition, newly designed anesthesia medical information system is under development. All of the advancement in anesthesia technologies facilitates advanced and complicated procedures in the thoracic surgery. It is hoped such advancement of anesthesiology will play roles in better treatment and outcome in patients undergoing respiratory and thoracic surgical procedures.
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The development of the computer technology brought reform in the field of medical equipment. Originally the mechanical ventilator was an instrument only as for running by pressure and the tool that let you breathe. However, it has a function to assist a measurement (tidal volume, peek pressure, etc.) and to wean from a ventilator. ⋯ After the operation without the complication, it seems that there is not the special administration. However, special respiratory management is necessary in case of chronic respiratory failure and acute lung injury, acute respiratory distress syndrome. Therefore I introduce a method to use a respirator after an operation in our institution.
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Swan-Ganz catheter (SGC : pulmonary artery catheter) was introduced in clinical use by Swan HJ and Ganz W in 1970. Since then, the catheter has been used in many kinds of clinical fields, such as critical care medicine, cardiovascular surgery, anesthesia, and cardiology, because of its useful functions. SGC can easily advance into the pulmonary artery with its flow-directed balloon. ⋯ Although SGC gives full diagnostic and therapeutic information of critically ill patients or cardiac surgical patients, all of the patients can not survive their tough critical clinical situation struggling with complications. Therefore, SGC has to be applied to the patients after thorough consideration whether the patients receive benefit of the catheter or not. Furthermore, the data obtained from SGC must be carefully interpreted to manage the patients.