Masui. The Japanese journal of anesthesiology
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Comparative Study
[A comparison of two methods for continuous cardiac output measurement: PulseCO VS CCO].
PulseCO (PulseCO) (PulseCO Hemodynamic Monitor, LiDCO Co., London, England) is a low invasive apparatus to measure cardiac output continuously from arterial pulse waveform. CCO (774 HF 75, Edwards Lifescience Co., California, USA) is a continuous cardiac monitor commonly used clinically. The purpose of this study is to compare the accuracy of these two methods for cardiac output measurement with the thermodilution technique (TDCO) as control. ⋯ PulseCO was low invasive, and showed a significantly better correlation with TDCO, compared with CCO.
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Randomized Controlled Trial Clinical Trial
[The influences of nitrous oxide and ketamine on electroencephalogram during propofol-anesthesia].
The influence of nitrous oxide and ketamine on electroencephalogram (EEG) during the induction of general anesthesia with propofol was quantitatively analyzed. ⋯ When anesthesia is induced with nitrous oxide and/or ketamine together with propofol, and BIS is taken as an index of depth of anesthesia, the intracerebral concentration of propofol becomes excess.
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The Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care (ECC) established in 2000 (Guidelines 2000) are the standard for cardiopulmonary resuscitation (CPR) all over the world. Written guidelines based on Basic Life Support (BLS) and Advanced Cardiac Life Support (ACLS) are widely available throughout Japan and are studied by physicians but ACLS training courses have been made available only recently. ⋯ In May, 2003 a total of 447 physicians from our hospital participated in a workshop on BLS which provided lectures, demonstrations and a written examination. After completion of this workshop, it has been concluded that standardization in the area of resuscitation is mandatory, and efforts to disseminate this workshop to health care practitioners are to be undertaken.
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We report here a case of upper airway obstruction occurring after extubation in a 55-yr-old 60 kg man after elective nephrectomy. Anesthesia was maintained with O2 (33%), N2O, sevoflurane (1.5-2%), and propofol infusion (2 mg x kg(-1) x hr(-1)). Blood loss was 1,965 ml, part of which was substituted by blood transfusion and albumin infusion. ⋯ Subsequent investigations using a fiberscope confirmed extensive soft tissue swelling, maximal at the level of the vocal cord and extending up- and down-wards to the trachea, indicating that the obstruction is caused by severe laryngeal edema. We believe that edema may have been caused by hypoalbuminemia (1.3 g x dl(-1)) at the end of operation. Therefore, it should be noted that hypoalbuminemia may cause laryngeal edema leading to acute airway obstruction.
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We report a case of severe intraoperative pulmonary edema during living related liver transplantation (LRLT) surgery. A 60-year-old woman with end-stage primary biliary cirrhosis underwent LRLT. ⋯ Further deterioration of hypoxemia was observed after reperfuion of the portal vein. We conclude that this severe pulmonary edema was caused by transfusion related acute lung injury, and prolonged ahepatic phase with reperfusion injury deteriorated the lung condition.