Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · May 1997
Case ReportsLarge increase in cardiac output in a patient with ARDS and acute right heart failure during inhalation of nitric oxide.
Inhaled nitric oxide (NO), a selective pulmonary vasodilator, reduces pulmonary artery pressure in patients with acute respiratory distress syndrome (ARDS). In spite of the reduction of right ventricular afterload, the effect of NO on cardiac output remains unclear. ⋯ Our observations suggest that inhalation of NO is likely to increase cardiac output in ARDS when severe acute right heart failure is present.
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Acta Anaesthesiol Scand · May 1997
GuidelineThe use of central regional anesthesia techniques in Sweden: results of a nation-wide survey. Swedish Association of Anesthesia and Intensive care.
Epidural and subarachnoid anesthesia are well established central regional techniques for surgical anesthesia. Two additional techniques, combined spinal epidural (CSE) block and continuous spinal anesthesia (CSA), have recently become popular. However, data on nation-wide use of central regional blocks are not available. ⋯ Subarachnoid block was preferred for shorter surgical procedures (< 60 min), whereas epidural and CSE blocks were chosen when severe postoperative pain could be anticipated, as continuous epidural analgesia was well established for postoperative pain management. Improved routines for registration of complications to central regional blocks are needed.
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Acta Anaesthesiol Scand · May 1997
Case ReportsIntraoperative epidural catheter malfunction in two obese patients.
Using a combined general anesthesia/epidural technique, two cases of intraoperative malfunctioning epidural catheters in obese patients are presented. After the epidural was found to be malfunctioning, the anesthesiologist placed the palm of both hands underneath the patients' lumbar and thoracic area. ⋯ In each case, this simple maneuver made the catheter function again. In conclusion, this simple corrective maneuver should be attempted prior to discarding the epidural anesthetic technique.
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Acta Anaesthesiol Scand · May 1997
Clinical TrialElastic work of breathing during continuous positive airway pressure in intubated patients with chronic obstructive pulmonary disease (theoretical analysis and experimental validation).
Continuous positive airway pressure (CPAP) is known to decrease inspiratory work of breathing in patients with chronic obstructive pulmonary disease (COPD). This effect is primarily attributed to a reduction in inspiratory elastic work of breathing (Wi,el) related to a decrease in intrinsic positive end-expiratory pressure (PEEP). ⋯ This study indicates that in order to reduce Wi,el in patients with COPD, intrinsic PEEP should be measured and the CPAP-level adjusted to the intrinsic PEEP-level.
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Acta Anaesthesiol Scand · May 1997
Postoperative analgesia in Italy. National survey on the anaesthetist's beliefs, opinions, behaviour and techniques in postoperative pain control in Italy.
Using a personal, anonymous questionnaire developed ad hoc, we tried to document the role, the problems and the activities of Italian anaesthetists in postoperative pain control. ⋯ This survey shows that Italian anaesthetists do not consider the postoperative period to be their own personal work area and that POA is to be considered as a matter of individual choice.