Masui. The Japanese journal of anesthesiology
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Historical Article
History of Resuscitation :4. Development of Resuscitation in the Mid-18 Century-4 : External Stimulation to the Body.
From the mid-18th century, several different stimulations were used to attempt to resuscitate apparently dead people. These include sound, smell, and light stimulation to the ear, nose and eyes, rubbing the body surface and spirit given to the oral cavity. ⋯ Galvani. Charles Kite developed the first electrical machine to stimulate the heart, and by 1800, it was found that the most effective site for applying electricity was over the heart.
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Patients with cardiac disease have high mortality rates, mainly owing to shock. Therefore, evaluation of cardiac function is one of the most challenging issues in the intensive and critical care unit. Cardiac point-of-care tests using ultrasound, such as focus assessed transthoracic echo (FATE) and rapid ultrasound in shock (RUSH). are useful for diagnosis and initial care of such patients. ⋯ A simple measurement method is described to evaluate the left and right ventricular function using mitral annular plane systolic excursion (MAPSE), mitral septal separation (MSS), and tricuspid annular plane systolic excursion (TAPSE). Next the RUSH protocol is discussed, which is useful for evaluation and care of patients with hypovolemic, cardiogenic, obstructive, or distributive shock. RUSH involves evaluation of the three main components : the pump (cardiac function, volume, pericardial function), the trunk (inferior vena cava, pleural fluid, lining), and the pipes (abdominal aneurysm, aortic dissection, deep vein thrombosis).
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Point-of-care ultrasound (POCUS) in the diagnoses of postoperative complications is discussed. POCUS is useful in many situations such as abdominal distension, elevated liver enzymes, abdominal pain, and fever, which are the common complications encountered after surgical operations. In the patients with abdominal distention, bowel distention or ascites can be easily detected by POCUS. ⋯ In patients with fever, US is useful not only for the diagnosis of abdominal abscess but also for the drainage. By evaluating the colon with POCUS, we can detect the pseudomembranous colitis which often is overlooked. In conclusion, POCUS is an essential tool for the proper management of postoperative patients.
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Fibrinogen replacement therapy con- tributes to effective hemostasis and saving blood trans- fusions in critical hemorrhage. We retrospectively studied the efficacy and indication for cryoprecipitate or fibrinogen concentrate in thoracic aortic surgery. ⋯ The fibrinogen amount of 2-3 g (per 50-70 kg in body weight) in cryoprecipitate or fibrino- gen concentrate effectively reduces postoperative bleeding and perioperative blood transfusions when a fibrinogen level is less than 100-130 mg · dl⁻¹ during cardiopulmonary bypass.
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Historical Article
[History of Resuscitation: 3. Development of Resuscitation in the Mid-18 Century-3: Artificial Respiration].
In the mid-18th century, resuscitation attempts started of "apparently dead" people as a result of drowning or other causes. In this article, I describe development of artificial ventilation. ⋯ Monro Secundus, Kite and Cullen attempted to ventilate via a tube which was inserted to. the mouth, nose or into the trachea. Gastric insufflation was pre- vented by a plug to the upper esophageal inlet and by cricoid pressure.