AANA journal
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The use of capnography during general anesthesia has become not only state of the art but also a recommended standard of care. In intubated patients, measurements of partial pressure of carbon dioxide in exhaled pulmonary gases approximate partial pressure of carbon dioxide in arterial blood under stable conditions. End-tidal carbon dioxide measurement has allowed anesthetists to continuously follow carbon dioxide concentration in exhaled gases; indirectly, it has enabled them to continuously monitor carbon dioxide concentration in arterial blood. ⋯ Recently, attention has focused on the utilization of capnography in sedated, nonintubated patients to follow carbon dioxide concentrations and access respiratory system function. This review of the current body of literature outlines development in capnography monitoring for sedated, nonintubated patients. Emphasis is placed on current techniques of measurement, the degree of correlation, and ramifications for clinical practice.
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The Ohmeda Tec 6 was designed as an agent-specific vaporizer for desflurane. Its exterior framework offers some unique features. Aside from its unique filling port, broad calibration range, and additional light-emitting diodes (LEDs), its large size literally sets it apart from all other models. ⋯ This is especially true in regard to the sump heating unit. Although there are many options to accommodate a high vapor pressure, a heating unit serves the purpose best. A brief review of vaporization and fundamental thermodynamics will demonstrate why this is so.
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Case Reports
An anesthetic for the adult patient with congenital tracheoesophageal fistula: a case report.
A 20-year-old male with a history of recurrent pneumonia was diagnosed as having an N-type tracheoesophageal fistula. A general anesthetic was planned to facilitate the repair of the tracheoesophageal fistula using a left anterior cervical approach. Intraoperatively, the surgeons were unable to identify the defect after surgical exposure. ⋯ Ease of identification allowed the tracheoesophageal fistula to be quickly repaired. At the completion of the surgery, the patient was extubated, and recovery was uneventful. The patient was discharged 48 hours postoperatively.