Masui. The Japanese journal of anesthesiology
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We evaluated the effects of anesthetic drugs and temperature on brain stem and mid-latency evoked potentials (BAEP and MLAEP) in 20-patients who were scheduled for elective cardiac operation using cardiopulmonary bypass with moderate hypothermia. At esophageal temperature of 36 degrees C, the latency of MLAEP was slightly prolonged by the increase of fentanyl dose, which suggested that the latency prolongation of MLAEP could not block the oscillation of auditory stimulation. ⋯ The latency of BAEP was markedly prolonged at 27 degrees C and returned to the normal latency at 36 degrees C. The latency of MLAEP retained by high dose fentanyl suggests that patients may be aware during cardiopulmonary bypass at normothermia, and BAEP may be one of the useful brain function monitors during cardiopulmonary bypass.
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PSV has been increasingly used as a partial ventilatory support for various types of respiratory failure. We experienced premature breath termination and double triggering in a patient with ARDS during PSV, and investigated the cause of this phenomenon using respiratory muscle pressure (Pmus). ⋯ The limitation of synchronization was attributable to fixed flow termination criteria in the present PSV algorithm. When dissynchronization is not manageable, other ventilatory modes (eg, APRV, PCV) allowing spontaneous ventilation should be considered as an alternative.