Abstract:
:Many indices are used to quantify pulmonary oxygen transfer. Indices that use only measurements from arterial blood and inspired gas assume a constant C(a-v)O2. Though variations in C(a-v)O2 are recognized, indices such as PaO2/FIO2 remain popular and are often considered the best measure of pulmonary oxygen transfer in critically ill patients. This study estimated the effect of within-subject variations in C(a-v)O2 and FIO2 on venous admixture (Qs/Qt), the calculated oxygen content difference between end-capillary and arterial blood (Cc'O2-CaO2), the alveolar-arterial oxygen tension gradient (P(A-a)O2) and PaO2/FIO2, using a validated lung model of acute respiratory distress syndrome (ARDS). All four indices showed changes with FIO2 and C(a-v)O2, although the magnitude of changes in Qs/Qt was clinically unimportant (<2%). The other three indices showed larger variations that may potentially be misleading. At an FlO2 of 0.7, PaO2 /FIO2 varied between 18 and 10 kPa and at an FIO2 of 0.9 the ratio varied between 22 and 8 kPa. These changes, which were unrelated to underlying lung pathology, are sufficiently large to result in misclassification on the gas exchange scale suggested by the American European Consensus Conference on ARDS. This study shows there is no reliable alternative to Qs/Qt to quantify pulmonary oxygen transfer in critically ill patients.
journal_name
Br J Anaesthjournal_title
British journal of anaesthesiaauthors
Nirmalan M,Willard T,Columb MO,Nightingale Pdoi
10.1093/bja/86.4.477subject
Has Abstractpub_date
2001-04-01 00:00:00pages
477-85issue
4eissn
0007-0912issn
1471-6771pii
S0007-0912(17)36417-6journal_volume
86pub_type
杂志文章abstract::A mathematical model of a subject breathing from a circle system has been used to follow the course of anaesthetic uptake during the simulated administration of 60% nitrous oxide, 2% halothane and 2% methoxyflurane, under non-rebreathing conditions and with fresh gas flows to the circle system of between 8 and 0.25 li...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/58.10.1167
更新日期:1986-10-01 00:00:00
abstract::We have studied the effects of alcuronium in 10 healthy, non-anaesthetized volunteers after they had been taking oral pyridostigmine 30 mg 8 hourly. The responses of adductor pollicis were recorded using an isolated forearm procedure (IFP) during onset and recovery of neuromuscular block produced by 1.5 mg of relaxant...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/66.3.365
更新日期:1991-03-01 00:00:00
abstract:BACKGROUND:Cyclic redistribution of air within the cuff during respiratory pressure changes creates a self-sealing mechanism which allows tracheal sealing, despite tracheal airway pressure being above baseline cuff inflation pressure. The aim of the present study was to investigate the effect of continuous automated cu...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aen355
更新日期:2009-02-01 00:00:00
abstract::We studied 133 women given a combined spinal-epidural for analgesia in labour. The initial intrathecal dose contained bupivacaine 2.5 mg with fentanyl 25 micrograms. When the mothers were comfortable, they were allocated randomly to one of three groups: continuous infusion (group Cl, n = 46), midwife top-ups (group MW...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/82.2.233
更新日期:1999-02-01 00:00:00
abstract:BACKGROUND:The Laryngeal Tube (LT) performs similarly to the classic laryngeal mask airway during controlled ventilation but with an improved airway seal. We compared the laryngeal tube with the ProSeal laryngeal mask airway (PLMA) throughout anaesthesia. METHODS:Thirty-two patients were studied using a randomized cro...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/aeg239
更新日期:2003-11-01 00:00:00
abstract:BACKGROUND:Chronic pain is no longer an effective warning system, but a syndrome with co-morbidities and many causes, needing a careful evaluation. Questions remain about the pain behaviour of chronic pain patients compared with patients with acute pain, or healthy subjects that we investigated. METHODS:We compared th...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1016/j.bja.2018.04.042
更新日期:2018-09-01 00:00:00
abstract::We have used the technique of double-blind sequential allocation to quantify the minimum local analgesic concentration (MLAC) of extradural bupivacaine for women in early (median cervical dilatation 2 cm) and late (median cervical dilatation 5 cm) labour. The first bolus was 20 ml of the bupivacaine test solution. The...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/bja/80.1.11
更新日期:1998-01-01 00:00:00
abstract::We have assessed the role of the cell-cell adhesion molecule, E-cadherin, in the pathogenesis of multiorgan failure in 24 intensive care patients with sepsis and varying degrees of organ dysfunction, compared with 21 healthy subjects. Plasma soluble E-cadherin (sE-cadherin) was measured by enzyme immunoassay. The medi...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/76.5.629
更新日期:1996-05-01 00:00:00
abstract:BACKGROUND:Age and diabetes mellitus have been identified as independent risk factors for cognitive decline after cardiac surgery with cardiopulmonary bypass (CPB). We tested the effects of CPB on cognitive function in aged and diabetic rats utilizing the Morris water maze (MWM). METHODS:Aged rats (26 months) were ran...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aem116
更新日期:2007-08-01 00:00:00
abstract::The circulating blood volume (CBV) of critically ill patients may be difficult to estimate on the basis of history and physical examination. The aim of this study was to evaluate the ability of seven clinical signs and central venous pressure (CVP) to predict CBV in critically ill patients; CBV was evaluated with the ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/86.6.754
更新日期:2001-06-01 00:00:00
abstract:BACKGROUND:Anaesthetic drugs act at sites within the brain that undergo profound changes during typical ageing. We postulated that anaesthesia-induced brain dynamics observed in the EEG change with age. METHODS:We analysed the EEG in 155 patients aged 18-90 yr who received propofol (n=60) or sevoflurane (n=95) as the ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aev213
更新日期:2015-07-01 00:00:00
abstract::We studied 52 adults undergoing elective craniotomy, allocated randomly to one of three opioid treatments: alfentanil 50 micrograms kg-1 followed by 0.833 microgram kg-1 min-1 until dural closure (group Alf.); alfentanil 50 micrograms kg-1 followed by 0.833 microgram kg-1 min-1 for 2 h, then remifentanil 0.25 microgra...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/81.3.361
更新日期:1998-09-01 00:00:00
abstract:BACKGROUND:The aim of this study was to test if intraoperative administration of N(2)O during propofol-remifentanil anaesthesia prevented the onset of postoperative opioid-induced hyperalgesia (OIH). METHODS:Fifty adult ASA I-II patients undergoing elective open septorhinoplasty under general anaesthesia were studied....
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aer323
更新日期:2011-12-01 00:00:00
abstract:BACKGROUND:Tracheal tube tip and cuff positions of different cuffed paediatric tracheal tube brands in the trachea can vary with design. METHODS:Data from three clinical studies with measured tracheal lengths were pooled in a database including 422 children aged from birth to 16 yr. Dimensional data of seven cuffed pa...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1016/j.bja.2018.05.002
更新日期:2018-08-01 00:00:00
abstract::Day-case anaesthesia requires rapidly eliminated anaesthetics which are relatively expensive. This multinational, multicentre European study assessed the relative costs of propofol or sevoflurane anaesthesia in 211 patients. Anaesthesia was induced and maintained with propofol in group 1, with propofol and sevoflurane...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1093/bja/83.4.564
更新日期:1999-10-01 00:00:00
abstract::Patients receiving opioids report feeling sleepy, but opioids actually inhibit the rapid eye movement phase of sleep (REM). Inhibition of REM sleep is followed by a rebound increase in REM sleep associated with cardiopulmonary complications. The medial pontine reticular formation (mPRF) is a brain region from which mo...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/74.2.188
更新日期:1995-02-01 00:00:00
abstract::Riluzole modulates several transmitter systems which may be involved in nociception. Antinociceptive effects have been shown in animal studies, but there are no human data. Therefore, we have examined the acute analgesic effect of riluzole in a human model of inflammatory pain induced by a thermal injury on the distal...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/82.5.718
更新日期:1999-05-01 00:00:00
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journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/58.9.1041
更新日期:1986-09-01 00:00:00
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journal_title:British journal of anaesthesia
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doi:10.1093/bja/ael286
更新日期:2007-01-01 00:00:00
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journal_title:British journal of anaesthesia
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doi:10.1093/bja/87.3.447
更新日期:2001-09-01 00:00:00
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journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/62.2.159
更新日期:1989-02-01 00:00:00
abstract::We have studied in eight rabbits the cardiovascular effects of midazolam, propofol and alfentanil with graded hypoxia. Central blood volume was reduced progressively by gradual inflation of a thoracic vena cava cuff so that cardiac index (CI) decreased at a constant rate. Under control conditions the haemodynamic resp...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/75.5.610
更新日期:1995-11-01 00:00:00
abstract::One hundred and forty male rats received a cryoinjury to a segment of the exposed sciatic nerve. A variety of temperatures and freeze patterns was used and the recovery of function was monitored. Where obvious nerve freezing occurred, the cryoinjury caused complete loss of function in the limb. The return of motor act...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/53.11.1121
更新日期:1981-11-01 00:00:00
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journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1016/j.bja.2018.06.006
更新日期:2018-10-01 00:00:00
abstract::We describe an obstetric patient who developed incapacitating headache after inadvertent dural tap and was treated with repeated blood patching. She subsequently developed severe lumbar back pain which, after exclusion of suspected extradural abscess, was treated successfully with simple analgesics and physiotherapy. ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/78.3.334
更新日期:1997-03-01 00:00:00
abstract::We describe an anaesthesia simulator capable of simulating all possible situations during anaesthesia. The Leiden anaesthesia simulator (LAS) may be used with most commercially available anaesthesia equipment and monitors, which are connected to the simulated patient as they are to a patient. A commercially available ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/73.3.287
更新日期:1994-09-01 00:00:00
abstract:BACKGROUND:We investigated the effects of spinal and general anaesthesia and surgical tourniquet on acute pain and early recovery after total knee arthroplasty (TKA). METHODS:Patients (n=413) were randomised to four parallel groups: spinal anaesthesia with or without tourniquet, and general anaesthesia with or without...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.bja.2020.03.036
更新日期:2020-11-01 00:00:00
abstract::A randomized, double-blind study of 40 women was performed to compare patient controlled anaesthesia (PCA) morphine requirements after spinal anaesthesia for elective Caesarean section. The women received 0.2 mg of either morphine or diamorphine mixed with 0.5% bupivacaine in 8% dextrose. There were no significant dif...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/81.2.135
更新日期:1998-08-01 00:00:00
abstract:BACKGROUND:Low fibrinogen (Fg) concentrations in trauma haemorrhage are associated with poorer outcomes. Cryoprecipitate is the standard source for Fg administration in the UK and USA and is often given in the later stages of transfusion therapy. It is not known whether early cryoprecipitate therapy improves clinical o...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
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更新日期:2015-07-01 00:00:00
abstract::Several risk scores have been developed to calculate the probability of postoperative nausea and vomiting (PONV). However, the power to discriminate which individual will suffer from PONV is still limited. Thus, we wondered how the number of predictors in a score affects the discriminating power and how the characteri...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/86.6.822
更新日期:2001-06-01 00:00:00