Journal of anesthesia
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Journal of anesthesia · Jan 2006
Randomized Controlled TrialEffects of a protease inhibitor, ulinastatin, on coagulation and fibrinolysis in abdominal surgery.
Ulinastatin is well known to inhibit the activity of polymorphonuclear leukocyte elastase (PMNE). The PMNE concentration correlates with the activities of coagulation and fibrinolysis. The purpose of the present study was to investigate the effects of ulinastatin, a protease inhibitor, on coagulation and fibrinolysis in abdominal surgery. ⋯ Ulinastatin could inhibit coagulation and fibrinolysis in abdominal surgery.
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Journal of anesthesia · Jan 2006
Randomized Controlled TrialEffect of peak inspiratory flow on gas exchange, pulmonary mechanics, and lung histology in rabbits with injured lungs.
The aim of this study was to evaluate, using a rabbit model, the little-known effect of different levels of peak inspiratory flow on acutely injured lungs. ⋯ In rabbits with injured lungs, high peak inspiratory flow with high tidal volume (V(T)) reduces the Pa(O(2))/FI(O(2)) ratio and increases the lung wet-to-dry ratio.
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Journal of anesthesia · Jan 2006
Randomized Controlled TrialFlexible, tapered-tip tube facilitates conventional orotracheal intubation by novice intubators.
Orotracheal intubation is the standard technique for airway management, but several untoward airway complications are possible with this method. To avoid airway trauma caused by the tube tip during intubation, the Parker Flex-Tip tube (PFT), which has a flexible, tapered tip, was developed. It has been reported that the PFT facilitates fiberoptic orotracheal intubation and introducer-guided tracheal intubation. ⋯ PFT did not shorten the time required for intubation and did not reduce the incidence of sore throat and hoarseness. However, a detailed analysis revealed that the PFT decreased the time required for intubation in the anesthesia trainee group. The PFT may help novice intubators to conduct a smooth intubation.
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Journal of anesthesia · Jan 2006
Clinical TrialRectal luminal Pr(CO2), measured by automated air tonometry, does not reflect gastric luminal Pr(CO2) in children.
Rectal luminal regional P(CO2) (Pr(CO2)) was compared with gastric luminal Pr(CO2) measured by automated air tonometry at intervals of 10 min in 20 children aged 6-16 years scheduled for elective surgery under general anesthesia. In 5 patients, measurement of rectal Pr(CO2) failed because of catheter-related problems. In the remaining 15 children, aged 10.6 +/- 2.5 years, 19 +/- 7 paired rectal and gastric Pr(CO2) values (n total, 241) were measured. ⋯ In patients with obvious feces in the rectum, bias (precision) for gastric compared to rectal Pr(CO2) was -2.7 kPa (2.6 kPa) and in those with empty rectum, -0.75 kPa (1.42 kPa; t-test; P < 0.001). Based on our in vivo data, rectal luminal Pr(CO2), measured by automated air tonometry, does not reflect gastric luminal Pr(CO2) in children. Enteral luminal gas production within feces in the rectum seems to be a major source of this disagreement.
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Journal of anesthesia · Jan 2006
Anandamide absorption by direct hemoperfusion with polymixin B-immobilized fiber improves the prognosis and organ failure assessment score in patients with sepsis.
Direct hemoperfusion (DHP) with polymixin B-immobilized fiber (PMX) has been reported to be effective for patients with septic shock. The aim of this study was to clarify the mechanism of PMX-DHP effect on septic shock. ⋯ ANA, an intrinsic cannabinoid that induces hypotension in septic shock, is inferred to be the main mechanism of the PMX-DHP effect. Removal of ANA by PMX-DHP could be key to successful septic shock treatment.