Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jun 1996
Clinical Trial Controlled Clinical Trial[Effect of arterial blood pressure on cerebral vein oxygen saturation in the rewarming phase of extracorporeal circulation].
This study concerns the effects of elevated mean arterial blood pressure (MAP) on decreases in jugular bulb oxygen saturation (SjO2) using fiberoptic jugular bulb oximetry and on cerebral blood flow velocity measured by transcranial Doppler sonography (TCD) during cardiopulmonary bypass (CPB) for coronary artery bypass graft (CABG). ⋯ The present data show decreases in Sjo2 during rewarming regardless to the level of arterial blood pressure (range 55-80 mmHg). This suggests that desaturation during rewarming of CPB is not a function of decreases in MAP since CBF autoregulation appears to be maintained within this pressure range.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jun 1996
[Postoperative mediastinal and subcutaneous emphysema after intubation narcosis].
The case of a 16-year old female is presented who underwent laparoscopy under general anaesthesia and uncomplicated endotracheal intubation. Four hours after uneventful anaesthesia and extubation the patient started vomiting and coughing. Subcutaneous tissue emphysema developed and pneumomediastinum was diagnosed on a chest roentgenogram. ⋯ A tracheal lesion during intubation is the most frequent and thus the most probable cause of air accumulation presenting as pneumomediastinum, pneumothorax or subcutaneous emphysema. As in the present case, increased airway pressure from vomiting or coughing even after a latent period may induce the phenomenon. Very occasional reports on spontaneous pneumomediastinum in young individuals must not detract the circumstances of endotracheal intubation from suspecting an iatrogenic lesion, confirming it by immediate endoscopy and thereupon deciding on conservative or surgical treatment.