Journal of clinical anesthesia
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Case Reports
Diagnosis of a left-sided superior vena cava during placement of a pulmonary artery catheter.
We report a case of a left sided superior vena cava (SVC) that was diagnosed during placement of a pulmonary artery (PA) catheter. After entering the left internal jugular, the PA catheter passed into the left side of the heart, through the aortic valve, and into the aorta. ⋯ The embryology and physiology of a left sided SVC is reviewed, including an historical perspective. A discussion of the variants of the syndrome is included, as is a review of aberrant placement of central venous catheters.
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To describe a method of the authors' design for estimating gastric volume quantitatively using ultrasound and to evaluate the usefulness of this method in the clinical setting. ⋯ This method would be useful to estimate gastric contents quantitatively, and a CSA of 8.0 cm2 might be a valid indicator of an empty stomach.
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To determine whether nitrogen insufflation reduces the laser-induced combustibility of polyvinyl chloride (PVC) endotracheal tube cuffs. ⋯ Nitrogen insufflation decreases CO2 laser-induced PVC endotracheal tube cuff combustibility. However, clinical applications of this technique should be undertaken with caution, as the administration of a hypoxic mixture may be possible.
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Less than a decade ago, the only nondepolarizing neuromuscular blocking drugs available to the anesthetist were traditional long-acting drugs such as pancuronium and d-tubocurarine. The revolution that began 10 years ago in our use of relaxants promises to continue unabated into the next decade. Changes in our clinical use of these drugs will be sparked not just by the introduction of new drugs but also by a greater understanding of the pharmacokinetic/pharmacodynamic principles that govern onset and recovery.