Abstract:
:Diaphragm strength can be assessed from twitch gastric (TwPgas), twitch oesophageal (TwPoes), and twitch transdiaphragmatic pressure (TwPdi) in response to phrenic nerve stimulation. This requires the passage of balloon catheters, which may be difficult. Changes in pressure measured at the mouth during phrenic nerve stimulation avoid the need for balloon catheters. We hypothesized that pressures measured at the tracheal tube during phrenic stimulation, could also reflect oesophageal pressure change as a result of isolated diaphragmatic contraction and, therefore, reflect diaphragm strength. We aimed to establish the relationship between twitch tracheal tube pressure (TwPet), TwPoes, and TwPdi in patients in the supine and sitting positions. The phrenic nerves were stimulated magnetically bilaterally, in 14 ICU patients while supine and on another occasion while sitting up at 45 degrees. In the sitting position mean TwPoes was 9.1 cm H2O and TwPet 11.3 cm H2O (mean(SD) difference -2.2 (SD 1.5)). In the supine position mean TwPoes was 8.1 cm H2O and TwPet 9.9 cm H2O (mean difference -1.8 (2.2)). The difference between TwPoes and TwPet was less at low twitch amplitude; less than +/- 1 cm H2O below a mean twitch height of 8 cm H2O supine and 10 cm H2O sitting. Sitting TwPet was related to TwPoes r2=0.93 and TwPdi r2=0.65 (P<0.01). Supine TwPet was related to TwPoes r2=0.84 and TwPdi r2=0.83 (P<0.01). The mean within occasion coefficient of variation while sitting was TwPet=13.3%, TwPoes=13.9%, TwPdi=11.2%, and supine TwPet=11.6%, TwPoes=14.6%, TwPdi=11.8%. We conclude that TwPet reflects TwPoes during diaphragmatic stimulation and is worthy of further study to establish its place as a guide to the presence of respiratory muscle strength and fatigue.
journal_name
Br J Anaesthjournal_title
British journal of anaesthesiaauthors
Mills GH,Ponte J,Hamnegard CH,Kyroussis D,Polkey MI,Moxham J,Green Mdoi
10.1093/bja/87.6.876subject
Has Abstractpub_date
2001-12-01 00:00:00pages
876-84issue
6eissn
0007-0912issn
1471-6771pii
S0007-0912(17)36591-1journal_volume
87pub_type
杂志文章abstract:BACKGROUND:We defined the nature of the pharmacological interaction after intrathecal co-administration of ginsenosides with clonidine, and clarified the contribution of the α-2 adrenoceptors on the effect of ginsenosides. METHODS:Pain was evoked by injection of a formalin solution (5%, 50 μl) into the hindpaw of male...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aeq367
更新日期:2011-03-01 00:00:00
abstract:BACKGROUND:The analgesia/nociception index (ANI), a 0-100 non-invasive index calculated from heart rate variability, reflects the analgesia/nociception balance during general anaesthesia. The aim of this study was to evaluate the ANI in the assessment of immediate postoperative pain in adult patients undergoing general...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aet110
更新日期:2013-09-01 00:00:00
abstract::The aim of this study was to find, using modern techniques, any histological differences in muscle biopsies between malignant hyperthermia (MH) susceptible (MHS), MH equivocal (MHE) and MH negative (MHN) patients. On the basis of the European MH contracture test carried out in 83 patients, 23 were shown to be MHS, nin...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/79.3.327
更新日期:1997-09-01 00:00:00
abstract::On accout of its histamine releasing and ganglion blocking properties tubocurarine is known to have significant haemodynamic effects. Methylation of the compound produces metocurine and should decrease both histamine release and ganglionic blockade. The haemodynamic effects of these two compounds were compared in 10 m...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/51.11.1007
更新日期:1979-11-01 00:00:00
abstract::It is generally accepted that halothane reduces airway and tissue resistance in lungs with preexisting airway tone. However, under conditions of resting airway tone, pulmonary resistance remains unaltered. In this study, we have determined the effects of halothane on respiratory system, pulmonary and chest wall resist...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/oxfordjournals.bja.a013443
更新日期:2000-03-01 00:00:00
abstract::The isolated rat hepatocyte model has been used to assess the hepatotoxicity of a number of i.v. anaesthetic induction agents. Ketamine, Althesin and CCI 12923 (minaxolone) all inhibited gluconeogenesis and urea formation from alanine. There was also a decrease in the cell ATP concentration, and a dose-related increas...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/51.8.733
更新日期:1979-08-01 00:00:00
abstract::We have studied the efficacy of preoxygenation using the Triservice Anaesthetic Apparatus (TSA) in healthy patients and found it to be unsatisfactory. An alternative technique suitable for field use was explored. The Mapleson D system (Bain) was found to be suitable for preoxygenation with a fresh gas flow of only 4 l...
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/66.2.196
更新日期:1991-02-01 00:00:00
abstract::Intravenous dose-response relationships for dimethyl tubocurarine showed that vagal blockade only became appreciable (50-83%) at doses 8-16 times those sufficient for full neuromuscular paralysis in anaesthetized cats (0.0625 mg/kg) and rhesus monkeys (0.125 mg/kg); heart rate was unchanged. Sympathetic function was u...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/48.9.847
更新日期:1976-09-01 00:00:00
abstract:BACKGROUND:Fast onset and short duration are prominent properties of the amide-type local anaesthetic articaine. Similar to bupivacaine, a hyperbaric solution of articaine may produce faster onset and shorter duration of spinal anaesthesia than a plain solution. METHODS:Patients undergoing open inguinal hernia repair ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aen294
更新日期:2008-12-01 00:00:00
abstract::Placental blood flow was measured during the first stage of normal labour using a xenon-133 clearance technique before and after segmental extradural analgesia. Analgesia was produced with 0.5% plain bupivacaine in eight patients and with 0.5% bupivacaine--adrenaline in 10 patients. Segmental extradural analgesia with...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/50.6.563
更新日期:1978-06-01 00:00:00
abstract::The oxygen delivery (DO2) and consumption (VO2) relationship in brain-dead organ donors is unknown. Therefore, in a prospective study, we determined the DO2/VO2 relationship in 21 consecutive brain-dead patients. Patients were allocated to one of two groups, according to plasma lactate concentration: normal (group NL,...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/76.6.783
更新日期:1996-06-01 00:00:00
abstract::The effects of doxacurium chloride, a new long-acting non-depolarizing neuromuscular blocking drug, on cardiac performance were studied in 45 patients undergoing high-dose fentanyl-diazepam-oxygen anaesthesia for cardiac surgery. Data were collected at baseline (10 min after tracheal intubation), and at 2, 5 and 10 mi...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/63.6.675
更新日期:1989-12-01 00:00:00
abstract::Patients with Munchausen's syndrome often undergo multiple surgical operations under general anaesthesia. They tend to have multiple exposures to routinely used anaesthetic agents. A patient with Munchausen's syndrome who developed an anaphylactoid reaction to thiopentone is described and the importance of obtaining p...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/59.11.1472
更新日期:1987-11-01 00:00:00
abstract::This is the report of a 55-yr-old female who developed severe myotonia and dystonia after general anaesthesia. Before starting on gabapentin therapy for a neuropathic pain condition, she had undergone numerous uneventful general anaesthetics. Since receiving treatment with gabapentin, she has experienced severe moveme...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aem130
更新日期:2007-08-01 00:00:00
abstract::Cobra venom consists of a neurotoxin which is responsible for respiratory paralysis simulating that associated with a non-depolarizing muscle relaxant. A combination of artificial respiration and neostigmine has been useful in resuscitating a child bitten by a snake. ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/49.10.1065
更新日期:1977-10-01 00:00:00
abstract:BACKGROUND:Descriptions of the pharmacokinetics and metabolism of morphine and its metabolites in young children are scant. Previous studies have not differentiated the effects of size from those related to age during infancy. METHODS:Postoperative children 0-3 yr old were given an intravenous loading dose of morphine...
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/aeh042
更新日期:2004-02-01 00:00:00
abstract:BACKGROUND:Patients undergoing non-cardiac, non-vascular surgery are at risk of major cardiovascular complications. In non-cardiac surgery, troponin elevation has previously been shown to be an independent predictor of major adverse cardiac events and postoperative mortality; however, a majority of studies have focused...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,meta分析,评审
doi:10.1093/bja/aew321
更新日期:2016-11-01 00:00:00
abstract:BACKGROUND:Fluid administration to increase stroke volume index (SVi) is a cornerstone of haemodynamic resuscitation. We assessed the accuracy of SVi variation during a calibrated abdominal compression manoeuvre (ΔSVi-CAC) to predict fluid responsiveness in children. METHODS:Patients younger than 8 yr with acute circu...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1016/j.bja.2018.06.030
更新日期:2018-12-01 00:00:00
abstract:BACKGROUND:Ketamine is used as an anaesthetic agent for short surgical procedures, and as a sedative and analgesic in intensive care patients. Intensive care patients with brain or spinal cord injury may have physiological changes that could alter the pharmacokinetics of ketamine. The pharmacokinetics of ketamine have ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aeg028
更新日期:2003-02-01 00:00:00
abstract::Bioactive substances in fresh frozen plasma (FFP) are considered to be related to adverse reactions after transfusion, particularly in septic or traumatized patients. Therefore, we analysed the concentration of various bioactive substances (histamine, eosinophil cationic protein, eosinophil protein X, myeloperoxidase ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/78.5.548
更新日期:1997-05-01 00:00:00
abstract::The effect of the combination of opiates and hypnotics on bispectral index (BIS) is unclear. This double-blind placebo-controlled trial investigated the effect on BIS and sedation of different infusion doses of remifentanil combined with a steady infusion of propofol. Forty patients initially received a target-control...
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/oxfordjournals.bja.a013474
更新日期:2000-04-01 00:00:00
abstract::Midazolam is often used for paediatric premedication. We have compared two methods of administering midazolam intranasally in 44 surgical day-case children allocated randomly to receive midazolam 0.2 mg kg-1 as drops or midazolam 0.1 mg kg-1 from an intranasal spray device. Behaviour was recorded on a four-point scale...
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/81.6.865
更新日期:1998-12-01 00:00:00
abstract::Thirty hypertensive patients scheduled for cholecystectomy or hernia repair under general anaesthesia with thiopentone-fentanyl-nitrous oxide-pancuronium were divided into two groups of 15. One group received metoprolol tablets 200 mg in a slow release form, once daily for at least 2 weeks including the morning of sur...
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/58.3.251
更新日期:1986-03-01 00:00:00
abstract::Experiments were performed on 14 anaesthetized, artifically ventilated dogs, in which efferent activity in the phrenic nerve was recorded and blood-gas tensions, arterial pH and core temperature were controlled. Doses of midazolam between 0.2 mg kg-1 and 2 mg kg-1 abolished phrenic nerve activity for periods between 3...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/56.10.1161
更新日期:1984-10-01 00:00:00
abstract::Sepsis is a constellation of clinical signs and symptoms resulting from excessive systemic host inflammatory response to infection. This inflammatory response is largely mediated by cytokines, which are released into the systemic circulation. Plasma concentrations of specific cytokines, TNF alpha, IL-1 beta, IL-6 and ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:10.1093/bja/77.1.110
更新日期:1996-07-01 00:00:00
abstract:Background:Experimental studies suggest that mechanical cell washing to remove pro-inflammatory components that accumulate in the supernatant of stored donor red blood cells (RBCs) might reduce inflammation and organ injury in transfused patients. Methods:Cardiac surgery patients at increased risk of large-volume RBC ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1093/bja/aex083
更新日期:2017-05-01 00:00:00
abstract:BACKGROUND:Intravenous amino acid infusion during general anaesthesia prevents decreases in core temperature resulting from increased energy expenditure and heat accumulation. METHODS:We investigated whether such stimulation also occurs during spinal anaesthesia, which blocks sympathetic nervous activity. We examined ...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:2003-01-01 00:00:00
abstract:BACKGROUND:The observation that patients presenting for bariatric surgery had a high incidence of neuromuscular blocking agent (NMBA) anaphylaxis prompted this restricted case-control study to test the hypothesis that obesity is a risk factor for NMBA anaphylaxis, independent of differences in pholcodine consumption. ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1016/j.bja.2020.12.018
更新日期:2021-01-13 00:00:00
abstract:BACKGROUND:The goal of the study was to determine activated thrombelastographic (TEG(R)) parameters with the rotational TEG(R) (ROTEG or ROTEM) device (Pentapharm GmbH, Munich, Germany) in neonates and infants <1 yr with complex congenital heart disease (CCHD) and to compare them with those of healthy children. METHOD...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/ael206
更新日期:2006-10-01 00:00:00
abstract::Cytokine synthesis and release is an essential component of the innate immune system, but inappropriate, excessive production results in a generalized systemic inflammatory response which damages distant organs. Recent research has identified an immunomodulatory function of the vagus nerve whereby activation of the ef...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:10.1093/bja/aep037
更新日期:2009-04-01 00:00:00