Journal of anesthesia
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Journal of anesthesia · Aug 2011
The usefulness of an earphone-type infrared tympanic thermometer during cardiac surgery with cardiopulmonary bypass: clinical report.
We evaluated the usefulness of a novel earphone-type infrared tympanic thermometer (IRT) during cardiac surgery with cardiopulmonary bypass. Tympanic membrane temperature (T(Tym)) was monitored using the IRT inserted into the right ear canal of 12 adult patients (ASA III) who had been scheduled for elective cardiac surgery with cardiopulmonary bypass under general anesthesia. Rectum (T(Rec)) and nasopharyngeal temperatures (T(Naso)) were also monitored, and all temperatures were recorded at 5-min intervals during cardiopulmonary bypass. ⋯ Significant correlations were seen between T(Tym) and T(Naso) (r = 0.971, P < 0.001), and T(Tym) and T(Rec) (r = 0.759, P < 0.001). A Bland-Altman plot showed that average temperature of T (Tym) was 0.06°C above T(Naso) (±0.66°C, 2 SD) and 0.12°C below T(Rec) (±1.78°C, 2 SD). We conclude that an earphone-type IRT is noninvasive and hygienic and could continuously evaluate selective cerebral temperature during cardiopulmonary bypass in adults.
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Journal of anesthesia · Aug 2011
Case ReportsCombination of extracorporeal membrane oxygenation and high-frequency oscillatory ventilation saved a child with severe ARDS after pulmonary resection.
We report a case in which a 2-year-old girl who underwent a right middle and lower lung lobectomy for congenital cystic adenomatoid malformation suffered massive bleeding and developed acute respiratory distress syndrome (ARDS) during the operation. She was ventilated with a high level of F(I)O(2) (0.75-1.0), PEEP (10-20 cmH(2)O), and PIP (33-55 cmH(2)O) to maintain SPO(2) (>90%). Following transfer to the ICU, continuous hemodialysis was introduced to reduce excessive blood volume. ⋯ ECMO was successfully weaned on POD 88. The patient required a tracheostomy, but she was able to function without a ventilator on POD 142. Although HFOV has failed to show a mortality benefit in ARDS patients, the unique lung recruitment by HFOV can be a useful therapeutic option for severe ARDS patients in combination with sufficient lung rest produced by ECMO.
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Journal of anesthesia · Aug 2011
Comparison of Laryngeal Mask Supreme® and Soft Seal® for airway management in several positions.
In emergency situations, rescuers occasionally must secure the airway while the patient is in a position other than the ideal supine position. We hypothesized that the laryngeal mask airway Supreme(®) (Supreme) may be useful for emergent airway management in several positions and compared the utility of the Supreme with that of the conventional Soft Seal(®) (Soft Seal) device. ⋯ Airway management attempts by novice doctors were more successful with the Supreme than the Soft Seal in the right-LT, prone, and sitting positions in the manikin. The Supreme may therefore be useful for emergent airway management.
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Journal of anesthesia · Aug 2011
Clinical TrialCombined use of adult fiberoptic bronchoscope and CARTO catheter for tracheal intubation in children with known difficult airway.
To find an alternative device to solve the difficult airway in children. ⋯ Combined use of adult FOB and CARTO catheter may be an alternative device for tracheal intubation in children with known difficult airway.
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Journal of anesthesia · Aug 2011
Case ReportsAnaphylaxis to pantoprazole during general anesthesia.
The most frequent causes of anaphylaxis during anesthesia are neuromuscular blocking agents, antibiotics, and latex. Proton pump inhibitors (PPI) are widely used during major surgery for the prevention of stress ulcers, but cases of perioperative anaphylactic reactions to these have rarely been reported. ⋯ After resuscitation, the patient recovered without any sequelae. Six months after the surgery, a skin test was positive to pantoprazole.