Anesthesia and analgesia
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Anesthesia and analgesia · Nov 2010
Improved accuracy of methemoglobin detection by pulse CO-oximetry during hypoxia.
Methemoglobin in the blood cannot be detected by conventional pulse oximetry and may bias the oximeter's estimate (Spo(2)) of the true arterial functional oxygen saturation (Sao(2)). A recently introduced "pulse CO-oximeter" (Masimo Rainbow SET® Radical-7) that measures SpMet, a noninvasive measurement of the percentage of methemoglobin in arterial blood (%MetHb), was shown to read spuriously high values during hypoxia. In this study we sought to determine whether the manufacturer's modifications have improved the device's ability to detect and accurately measure methemoglobin and deoxyhemoglobin simultaneously. ⋯ The Rainbow's methemoglobin readings are acceptably accurate over an oxygen saturation range of 74%-100% and a methemoglobin range of 0%-14%.
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Anesthesia and analgesia · Nov 2010
Case ReportsCase report: pediatric liver retransplantation on an extracorporeal membrane oxygenation-dependent child.
We describe the perioperative management of a venovenous extracorporeal membrane oxygenator-dependent child requiring liver retransplantation after emergent hepatectomy because of an ischemic liver graft. This child required renal replacement and inotropic support as well as treatment for heparin-induced thrombocytopenia (HIT). We describe each step in this child's perioperative management leading to the successful liver retransplantation. This is the first description, to our knowledge, of a pediatric patient undergoing liver transplantation while supported by extracorporeal membrane oxygenation (ECMO).
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Anesthesia and analgesia · Nov 2010
Opioid-induced preconditioning is dependent on caveolin-3 expression.
We tested the hypothesis that caveolin-3 (Cav-3) is essential for opioid-induced preconditioning in vivo. Cav-3 overexpressing mice, Cav-3 knockout mice, and controls were exposed to myocardial ischemia/reperfusion (I/R) in the presence of SNC-121 (SNC), a δ-selective opioid agonist, or naloxone, a nonselective opioid antagonist. ⋯ Cav-3 overexpressing mice showed innate protection from I/R compared with controls that was abolished by naloxone. Our results show that opioid-induced preconditioning is dependent on Cav-3 expression and that endogenous protection in Cav-3 overexpressing mice is opioid dependent.
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Anesthesia and analgesia · Nov 2010
Multicenter Study Comparative StudyHeart-type fatty acid binding protein is an independent predictor of death and ventricular dysfunction after coronary artery bypass graft surgery.
Heart-type fatty acid binding protein (hFABP) functions as a myocardial fatty acid transporter and is released into the circulation early after myocardial injury. We hypothesized that hFABP is superior to conventional cardiac biomarkers for predicting early perioperative myocardial injury after coronary artery bypass graft (CABG) surgery. ⋯ Compared with traditional markers of myocardial injury after CABG surgery, hFABP peaks earlier and is a superior independent predictor of postoperative mortality and ventricular dysfunction.