Journal of cardiothoracic anesthesia
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J Cardiothorac Anesth · Aug 1990
Randomized Controlled Trial Clinical TrialValue and accuracy of dual oximetry during pulmonary resections.
During thoracic surgery, one-lung ventilation (1LV) is often required. The purpose of this prospective study was to examine the usefulness and accuracy of dual-oximetry during 1LV. Prior to the induction of anesthesia, 30 patients had a radial artery and a fiberoptic pulmonary artery catheter (15 Edwards, 15 Spectramed by randomization) inserted. ⋯ SpO2 less than 95% reflects hypoxygenation and hypoxia (PaO2 less than or equal to 70 mm Hg). SvO2 is determined primarily by oxygenation (r = 0.005; P less than or equal to 0.05) rather than by CI (r = 0.001, ns). Since DO2I increased during 1LV to maintain the oxygen supply and demand balance, SvO2 monitoring might be useful as an early indicator in identifying high-risk patients with compromised DO2I resulting from decreased CI.
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J Cardiothorac Anesth · Aug 1990
Clinical TrialEnoximone treatment of impaired myocardial function during cardiac surgery: combined effects with epinephrine.
Enoximone belongs to a new class of noncatecholamine-positive inotropes, which selectively inhibit phosphodiesterase type III and increase cyclic AMP (cAMP). This study was performed in 30 coronary artery surgery patients with impaired myocardial function (ejection fraction [EF] less than 50%). The study's two purposes were to investigate the hemodynamic effects of enoximone, 0.5 mg/kg, administered following induction of anesthesia (phase I), and to assess whether enoximone can potentiate the actions of sympathomimetic agents during weaning from cardiopulmonary bypass (CPB) (phase II). ⋯ Weaning was successful in both groups, but the combined therapy produced a larger increase in cl and a more pronounced decrease of the elevated filling pressure (PCWP). PAP was not changed in the combined therapy group, but increased in the patients receiving epinephrine alone. It is concluded that enoximone has beneficial hemodynamic effects in the perioperative period, and that potentiation of the effects of epinephrine in severe heart failure may be one of the drug's most useful features.
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J Cardiothorac Anesth · Aug 1990
Predicting arterial oxygenation during one-lung ventilation with continuous positive airway pressure to the nonventilated lung.
Forty patients undergoing elective thoracotomy were studied to assess the possibility of predicting PaO2 during one-lung ventilation (OLV) when continuous positive airway pressure (CPAP) was applied to the nondependent lung. The first 20 patients were studied retrospectively and the three most significant independent variables that correlated with PaO2 during OLV with CPAP were: side of operation (P = 0.04), FEV1/FVC ratio (P = 0.01), and the intraoperative PaO2 during two-lung ventilation (P = 0.0002). ⋯ The second 20 patients were studied prospectively and the predicted PaO2 correlated significantly with the observed PaO2 during OLV with CPAP (r = 0.86, P less than 0.001). Therefore, it is concluded that the PaO2 during OLV with CPAP can be predicted using routinely available data.