Journal of anesthesia
-
Journal of anesthesia · Jan 2008
Case ReportsAn unusual case of airway obstruction at the tip of an endotracheal tube caused by insertion of a nasogastric tube.
We report an unusual case of ventilatory impediment caused by the obstruction of an endotracheal tube (ETT) by a nasogastric (NG) tube. A 72-year-old woman with bronchial asthma was scheduled for colostomy closure. An ETT of 7.5-mm internal diameter (ID) could not be advanced, and finally a 5.0-mm ID ETT was placed, because she had post-intubation tracheal stenosis. ⋯ She was treated for an asthmatic attack, but her respiratory condition did not recover. We then exchanged the ETT for a laryngeal mask airway (LMA) and removed the NG tube. It was suspected that the cause of the airway obstruction was that the NG tube in the esophagus compressed the membranous portion of the stenotic trachea and the tip of the ETT was obstructed.
-
Journal of anesthesia · Jan 2008
Comparative StudyChanges in polymorphonuclear leukocyte elastase concentrations and hemolysis parameters in patients transfused with different blood preparations, and in the blood preparations themselves.
Massive blood transfusion induces hemolysis and increases polymorphonuclear leukocyte elastase (PMNE) concentration. The purpose of this study was to compare hemolysis and PMNE concentrations in massive blood transfusions with three different preparations. ⋯ During the storage of MAP-CRC, CPD-CRC, and WB, CPD-CRC had the greatest hemolysis and WB had the highest concentration of PMNE. Patients who received massive blood transfusion of MAP-CRC had the least hemolysis and the lowest concentration of PMNE.
-
Journal of anesthesia · Jan 2008
Randomized Controlled TrialThe effect of heat-moisture exchanger and closed-circuit technique on airway climate during desflurane anesthesia.
We assessed whether closed-circuit anesthesia (CCA) could provide a more favorable airway climate than semi-closed anesthesia (SCA), and we also determined the beneficial effect of heat moisture exchangers (HMEs) on the preservation of airway climate during desflurane anesthesia. ⋯ CCA was much more advantageous than SCA for maintaining the patient's airway climate during the 2-h study. The beneficial effect of HME on the airway climate should be emphasized, especially in patients undergoing general anesthesia.
-
Journal of anesthesia · Jan 2008
Comparative StudyComparison of oxygen consumption calculated by Fick's principle (using a central venous catheter) and measured by indirect calorimetry.
We investigated the clinical usefulness of the Fick method using central venous oxygen saturation ScvO2 and cardiac output (CO) measured by pulse dye densitometry (PDD) for monitoring oxygen consumption VO2. This prospective clinical study was performed in 28 mechanically ventilated postoperative patients after major abdominal surgery. VO2 was determined by two methods, i.e., the Fick method and indirect calorimetry. ⋯ VO2 values determined by the Fick method were significantly lower than those measured by indirect calorimetry (110 +/- 29 vs 148 +/- 28 ml x min(-1) x m(-2); P < 0.01). Bland and Altma analysis showed that the mean bias and precision were 33 ml x min(-1) x m(-2) and 32 ml x min(-1) x m(-2), respectively. The correlation between the two measurements of VO2 was weak (r (2) = 0.145; P = 0.0038), indicating that the Fick method using PDD and ScvO2 is not clinically acceptable for the monitoring of VO2.