Abstract:
BACKGROUND:Cerebral embolization is a primary cause of cardiac surgical neurologic morbidity. During cardiopulmonary bypass (CPB), there are well-defined periods of embolic risk. In theory, cerebral embolization might be reduced by an increase in pump flow during these periods. The purpose of this study was to determine the CPB flow-embolization relation in a canine model. METHODS:Twenty mongrel dogs underwent CPB at 35 degrees C with alpha-stat management and a fentanyl-midazolam anesthetic. In each animal, CPB flow was adjusted to achieve a mean arterial pressure of 65-75 mmHg. During CPB, an embolic load of 1.2 x 10(5) 67 microm fluorescent microspheres was injected into the arterial inflow line. Before and after embolization, cerebral blood flow was determined using 15-microm microspheres. Tissue was taken from 12 brain regions and microspheres were recovered. The relation between pump flow and embolization/g of brain was determined. RESULTS:The mean arterial pressure at embolization was 67 +/-4 mmHg, and the range of pump flow was 0.9-3.5 l x min(-1)x m(-2). Cerebral blood flow was independent of pump flow. At lower pump flow, the percentage of that flow delivered to the brain increased. There was a strong inverse relation between pump flow and cerebral embolization (r = -0.708, P < 0.000 by Spearman rank order correlation). CONCLUSIONS:Cerebral embolization is determined by the CPB flow. At an unchanged mean arterial pressure, as pump flow is reduced, a progressively greater proportion of that flow is delivered to the brain.
journal_name
Anesthesiologyjournal_title
Anesthesiologyauthors
Sungurtekin H,Plöchl W,Cook DJdoi
10.1097/00000542-199911000-00031subject
Has Abstractpub_date
1999-11-01 00:00:00pages
1387-93issue
5eissn
0003-3022issn
1528-1175journal_volume
91pub_type
杂志文章相关文献
ANESTHESIOLOGY文献大全abstract:BACKGROUND:alpha 2 Agonists are powerful analgesics after spinal delivery. The current work characterizes the dose-dependent antinociception and effects upon respiratory function of dexmedetomidine after intrathecal, epidural, intravenous, and intracisternal delivery in chronically prepared dogs. METHODS:Dogs were pre...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199405000-00015
更新日期:1994-05-01 00:00:00
abstract:BACKGROUND:Suboptimal tissue perfusion and oxygenation during surgery may be responsible for postoperative nausea and vomiting in some patients. This trial tested the hypothesis that muscular tissue oxygen saturation-guided intraoperative care reduces postoperative nausea and vomiting. METHODS:This multicenter, pragma...
journal_title:Anesthesiology
pub_type: 杂志文章,多中心研究
doi:10.1097/ALN.0000000000003305
更新日期:2020-08-01 00:00:00
abstract::Transient hyperreflexia, the Babinski reflex, and other transient neurologic signs may follow anesthesia in healthy persons. The authors describe the appearance and durations of these signs and relate them to anesthetic agent, time following cessation of anesthesia, and state of arousal. Twenty-nine neurologically nor...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-198102000-00005
更新日期:1981-02-01 00:00:00
abstract:BACKGROUND:Selective breeding produces animal strains with varying anesthetic sensitivity. It thus seems unlikely that various human ethnicities have identical anesthetic requirements. Therefore, the authors tested the hypothesis that the minimum alveolar concentration of sevoflurane differs significantly as a function...
journal_title:Anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/01.anes.0000267534.31668.62
更新日期:2007-07-01 00:00:00
abstract::To determine whether anesthesiologists, because of prolonged exposure to halothane or other inhalational anesthetics, might have higher death rates from all causes, from cancer, and from hepatic or renal disease than other physicians, the mortality rates of male and female members of the American Society of Anesthesio...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-197909000-00003
更新日期:1979-09-01 00:00:00
abstract:BACKGROUND:The authors conducted a randomized, controlled, parallel-arm, superiority study to test the hypothesis that a continuous adductor canal block decreases the time to attain four discharge criteria compared with a continuous femoral nerve block after tricompartment knee arthroplasty. METHODS:Subjects undergoin...
journal_title:Anesthesiology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1097/ALN.0000000000000741
更新日期:2015-08-01 00:00:00
abstract:BACKGROUND:Cerebral injury is among the most common and disabling complications of open heart surgery. Attempts to provide neuroprotection have yielded conflicting results. We assessed the potential of propofol-induced burst suppression during open heart surgery to provide cerebral protection as determined by postopera...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1097/00000542-199905000-00006
更新日期:1999-05-01 00:00:00
abstract:BACKGROUND:Dexmedetomidine is a sedative with modest analgesic efficacy, whereas remifentanil is an opioid analgesic with modest sedative potency. Synergy is often observed when sedative-hypnotics are combined with opioid analgesics in anesthetic practice. A three-phase crossover trial was conducted to study the pharma...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章
doi:10.1097/ALN.0000000000002882
更新日期:2019-11-01 00:00:00
abstract:BACKGROUND:Mechanical ventilation is delivered to sedated patients during anesthesia, but also to nonsedated patients (ventilator weaning, noninvasive ventilation). In these circumstances, patient-ventilator asynchrony may occur, provoking discomfort and unduly increasing work of breathing. In certain cases, it is asso...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/01.anes.0000287005.58761.e8
更新日期:2007-11-01 00:00:00
abstract:BACKGROUND:The authors determined the segmental effects of intracarotid verapamil in human subjects by using a novel method of measuring proximal and distal cerebrovascular resistance. Their hypothesis was that intracarotid verapamil, a calcium channel-blocking drug that augments cerebral blood flow and reverses arteri...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200404000-00005
更新日期:2004-04-01 00:00:00
abstract:BACKGROUND:Clinically used general anesthetics, alone or in combination, are damaging to the developing mammalian brain. In addition to causing widespread apoptotic neurodegeneration in vulnerable brain regions, exposure to general anesthesia at the peak of synaptogenesis causes learning and memory deficiencies later i...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0b013e3182303a63
更新日期:2011-11-01 00:00:00
abstract:BACKGROUND:Anesthesia personnel are at risk for occupational infection with bloodborne pathogens from contaminated percutaneous injuries (CPIs). Additional information is needed to formulate methods to reduce risk. METHODS:The authors analyzed CPIs collected during a 2-yr period at 11 hospitals, assessed CPI underrepo...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1097/00000542-199812000-00013
更新日期:1998-12-01 00:00:00
abstract:BACKGROUND:Sugammadex (Org 25969) forms a complex with steroidal neuromuscular blocking agents, thereby reversing neuromuscular block. This study investigated the dose-response relation, safety, and pharmacokinetics of sugammadex to reverse rocuronium-induced block. METHODS:Twenty-seven male surgical patients aged 18-...
journal_title:Anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/00000542-200604000-00009
更新日期:2006-04-01 00:00:00
abstract:BACKGROUND:Hyperkalemic cardiac arrest after the administration of succinylcholine (SCh) to critically ill intensive care patients has been attributed to changes in the acetylcholine receptors (AChRs) at the muscle membrane. The current study attempts to characterize the contributory roles of chronic administration of ...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199602000-00017
更新日期:1996-02-01 00:00:00
abstract:BACKGROUND:Halogenated anesthetics potentiate the positive inotropic effects of alpha- and beta-adrenoceptor stimulations. Although diabetes mellitus induces significant myocardial abnormalities, the interaction of halogenated anesthetics and adrenoceptor stimulation in diabetic myocardium remains unknown. METHODS:Lef...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200411000-00014
更新日期:2004-11-01 00:00:00
abstract:BACKGROUND:Tracheal intubation frequently results in reversible bronchoconstriction. Propofol has been reported to minimize this response in healthy patients and in asthma patients, but may be unsuitable for hemodynamically unstable patients for whom etomidate may be preferable. The current study examined respiratory r...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000542-199606000-00005
更新日期:1996-06-01 00:00:00
abstract:WHAT WE ALREADY KNOW ABOUT THIS TOPIC:WHAT THIS ARTICLE TELLS US THAT IS NEW: BACKGROUND:: Hypotension is a risk factor for adverse perioperative outcomes. Machine-learning methods allow large amounts of data for development of robust predictive analytics. The authors hypothesized that machine-learning methods can prov...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0000000000002374
更新日期:2018-10-01 00:00:00
abstract::The effect of neuromuscular blockade with vecuronium on the hemodynamic responses to a noxious stimulus was investigated in male Sprague-Dawley rats. The rats were anesthetized with either halothane (group 1, n = 10), or isoflurane (group 2, n = 10). The maximum values for heart rate and mean arterial pressure during ...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-198908000-00009
更新日期:1989-08-01 00:00:00
abstract:BACKGROUND:Preanesthesia medical examination is a common procedure performed before ophthalmic surgery. The frequency and characteristics of new medical issues and unstable medical conditions revealed by ophthalmic preanesthesia medical examination are unknown. We conducted a prospective observational study to estimate...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0b013e31828ea5b2
更新日期:2013-05-01 00:00:00
abstract::The authors determined the effect of profound induced hypotension (i.e., mean arterial blood pressure less than 50 mmHg) during craniotomy for cerebral aneurysm on cerebral blood flow and cerebral metabolic rate for oxygen before, during, and after (20 min and 40 min after) the hypotensive period. The study was perfor...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-198902000-00013
更新日期:1989-02-01 00:00:00
abstract:BACKGROUND:Some inhalation anesthetics increase apoptotic cell death in the developing brain. Xenon, an inhalation anesthetic, increases neuroprotection when combined with therapeutic hypothermia after hypoxic-ischemic brain injury in newborn animals. The authors, therefore, examined whether there was any neuroapoptoti...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0b013e318294934d
更新日期:2013-08-01 00:00:00
abstract:BACKGROUND:Human newborns, particularly those born before full term, are more susceptible to bacterial infections as a result of impaired host defense mechanisms. Compared with adults, circulating leukocytes from human newborns (preterm and full-term gestations) and newborn rabbits (full-term gestation) have low restin...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199702000-00017
更新日期:1997-02-01 00:00:00
abstract::The antinociceptive interaction on the tail flick (TF) and hot plate (HP) tests between opioid analgesics and medetomidine after intravenous (iv) or intrathecal administration were examined by isobolographic analysis. Male Sprague-Dawley rats received fixed ratios of medetomidine to morphine, fentanyl, and meperidine ...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199012000-00022
更新日期:1990-12-01 00:00:00
abstract:BACKGROUND:Age is often the sole criterion for determining the need for preoperative electrocardiograms. However, screening electrocardiograms have not been shown to add value above clinical information. This study was designed to determine whether it is possible to target electrocardiograms ordering to patients most l...
journal_title:Anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/ALN.0b013e31819fb139
更新日期:2009-06-01 00:00:00
abstract:BACKGROUND:Up to 84% of women who undergo operative vaginal delivery receive neuraxial analgesia. However, little is known about the association between neuraxial analgesia and neonatal morbidity in women who undergo operative vaginal delivery. The authors hypothesized that neuraxial analgesia is associated with a redu...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0000000000003589
更新日期:2021-01-01 00:00:00
abstract:BACKGROUND:One-lung ventilation (OLV) results in alveolar proinflammatory effects, whereas their extent may depend on administration of anesthetic drugs. The current study evaluates the effects of different volatile anesthetics compared with an intravenous anesthetic and the relationship between pulmonary and systemic ...
journal_title:Anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/ALN.0b013e318214b9de
更新日期:2011-07-01 00:00:00
abstract:BACKGROUND:Hypotension is a common side effect of general anesthesia induction, and when severe, it is related to adverse outcomes. Ultrasonography of inferior vena cava (IVC) is a reliable indicator of intravascular volume status. This study investigated whether preoperative ultrasound IVC measurements could predict h...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0000000000001002
更新日期:2016-03-01 00:00:00
abstract::The cerebral and systemic hemodynamic and metabolic effects of hypotension induced with desflurane were examined in 11 dogs. During a steady-state baseline period under 1 MAC desflurane (7.2%), the following were measured or derived: arterial, pulmonary artery, and pulmonary artery occlusion pressures; arterial, mixed...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199103000-00021
更新日期:1991-03-01 00:00:00
abstract:BACKGROUND:Opioids are used by patients who have conditions ranging from the acute pain of surgery and chronic cancer pain to substance abuse. Despite their widespread use and considerable experimental data about them, little is known about how opioids may alter in vivo immunity in humans. This study was designed to ev...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199509000-00008
更新日期:1995-09-01 00:00:00
abstract:BACKGROUND:It should be possible to avoid variations in plasma glucose concentration during anesthesia by adjusting glucose infusion rate to whole-body glucose uptake. To study this hypothesis, we measured glucose utilization and production, before and during halothane anesthesia. METHODS:After an overnight fast, six ...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199505000-00010
更新日期:1995-05-01 00:00:00