Changes in respiratory mechanics during cardiac surgery.

Abstract:

UNLABELLED:We investigated the role of cardiopulmonary bypass (CPB) in compromised lung function associated with cardiac surgery. Low-frequency respiratory impedance (Zrs) was measured in patients undergoing cardiac surgery with (n = 30; CPB group) or without (n = 29; off-pump coronary artery bypass [OPCAB] group) CPB. Another group of CPB patients received dopamine (DA) (n = 12; CPB-DA group). Extravascular lung water was determined in five CPB subjects. Zrs was measured before skin incision and after chest closure. Airway resistance and inertance and tissue damping and elastance were determined from Zrs data. Airway resistance increased in the CPB group (74.9% +/- 20.8%; P < 0.05), whereas it did not change in the OPCAB group (11.8% +/- 7.9%; not significant) and even decreased in the CPB-DA patients (-40.6% +/- 9.2%; P < 0.05). Tissue damping increased in the CPB and OPCAB groups, whereas it remained constant in the CPB-DA patients. Significant increases in elastance were observed in all groups. There was no difference in extravascular lung water before and after CPB, suggesting that edema did not develop. These results indicate a significant and heterogeneous airway narrowing during CPB, which was counteracted by the administration of DA. The mild deterioration in tissue mechanics, reflecting partial closure of the airways, may be a consequence of the anesthesia itself. IMPLICATIONS:We observed that cardiopulmonary bypass deteriorates lung function by inducing a heterogeneous airway constriction, whereas no such effects were observed in patients undergoing cardiac surgery without bypass. The impairment in parenchymal mechanics, which was obtained in both groups, may result from peripheral airway closure and/or be a consequence of mediator release.

journal_name

Anesth Analg

journal_title

Anesthesia and analgesia

authors

Babik B,Asztalos T,Peták F,Deák ZI,Hantos Z

doi

10.1213/01.ane.0000055363.23715.40

subject

Has Abstract

pub_date

2003-05-01 00:00:00

pages

1280-7, table of contents

issue

5

eissn

0003-2999

issn

1526-7598

journal_volume

96

pub_type

临床试验,杂志文章
  • Controversies in the Postoperative Management of the Critically Ill Heart Transplant Patient.

    abstract::Heart transplant recipients are susceptible to a number of complications in the immediate postoperative period. Despite advances in surgical techniques, mechanical circulatory support (MCS), and immunosuppression, evidence supporting optimal management strategies of the critically ill transplant patient is lacking on ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,评审

    doi:10.1213/ANE.0000000000004220

    authors: Shen T,Huh MH,Czer LS,Vaidya A,Esmailian F,Kobashigawa JA,Nurok M

    更新日期:2019-10-01 00:00:00

  • Succinylcholine-vecuronium (Org NC 45) sequence for cesarean section.

    abstract::Vecuronium (Org NC 45) was used in 27 parturients undergoing elective cesarean section under general anesthesia. One of the parturients had a twin pregnancy. Neuromuscular transmission was assessed clinically by stimulating the ulnar nerve and observing the contraction of the fingers. An initial bolus of 0.05 mg . kg-...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:

    authors: Baraka A,Noueihed R,Sinno H,Wakid N,Agoston S

    更新日期:1983-10-01 00:00:00

  • A randomized, double-blinded study of remifentanil versus fentanyl for tonsillectomy and adenoidectomy surgery in pediatric ambulatory surgical patients.

    abstract:UNLABELLED:We compared, in a double-blinded manner, the anesthetic maintenance and recovery properties of remifentanil with a clinically comparable fentanyl-based anesthetic technique in pediatric ambulatory surgical patients. Anesthesia was induced with either halothane or sevoflurane and nitrous oxide and oxygen. Pat...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

    doi:10.1097/00000539-200004000-00017

    authors: Davis PJ,Finkel JC,Orr RJ,Fazi L,Mulroy JJ,Woelfel SK,Hannallah RS,Lynn AM,Kurth CD,Moro M,Henson LG,Goodman DK,Decker MD

    更新日期:2000-04-01 00:00:00

  • The prevalence and significance of low preoperative hemoglobin in ASA 1 or 2 outpatient surgery candidates.

    abstract::Asymptomatic anemia in healthy patients undergoing low risk surgery is rare. In this retrospective study, we examined the records of 9584 ASA class I-II patients scheduled for elective low risk surgery who had a preoperative hemoglobin (hgb) test for the presence of anemia. Hgb <9 g/dL was detected in 75 patients (0.8...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/01.ANE.0000180836.02142.E6

    authors: Olson RP,Stone A,Lubarsky D

    更新日期:2005-11-01 00:00:00

  • Effects of fentanyl, naloxone, and clonidine on hemodynamics and plasma catecholamine levels in dogs.

    abstract::A 50-micrograms/kg dose of fentanyl, given intravenously in divided doses to dogs under enflurane-nitrous oxide anesthesia caused sharp decreases in heart rate (HR), arterial blood pressure (AP), left ventricular dP/dt, and plasma levels of catecholamines. Naloxone, 20 micrograms/kg given 65-70 min later, completely a...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:

    authors: Flacke JW,Flacke WE,Bloor BC,Olewine S

    更新日期:1983-03-01 00:00:00

  • Prophylactic antiemetics for laparoscopic cholecystectomy: ondansetron versus droperidol plus metoclopramide.

    abstract::Two hundred adults undergoing laparoscopic cholecystectomy were enrolled in a prospectively randomized, double-blind investigation comparing ondansetron, 4 mg (Group O) with the combination of droperidol, 0.625 mg, and metoclopramide, 10 mg (Group DM). Antiemetic drugs were administered intravenously (IV) after induct...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000539-199611000-00032

    authors: Steinbrook RA,Freiberger D,Gosnell JL,Brooks DC

    更新日期:1996-11-01 00:00:00

  • Administration of local anesthetic through the epidural needle before catheter insertion improves the quality of anesthesia and reduces catheter-related complications.

    abstract::Epidural catheter placement offers flexibility in block management. However, during epidural catheter insertion, complications such as paresthesia and venous and subarachnoid cannulation may occur, and suboptimal catheter placement can affect the quality of anesthesia. We performed this prospective, randomized, double...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1213/01.ANE.0000181005.50958.1E

    authors: Cesur M,Alici HA,Erdem AF,Silbir F,Yuksek MS

    更新日期:2005-11-01 00:00:00

  • Teaching lifesaving procedures: the impact of model fidelity on acquisition and transfer of cricothyrotomy skills to performance on cadavers.

    abstract:BACKGROUND:A decline in emergency surgical airway procedures in recent years has resulted in a decreased exposure to cricothyrotomy. Consequently, residents have very little experience or confidence in performing this intervention. In this study, we compared cricothyrotomy skills acquired on a simple inexpensive model ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ane.0b013e3181841efe

    authors: Friedman Z,You-Ten KE,Bould MD,Naik V

    更新日期:2008-11-01 00:00:00

  • Pediatric Regional Anesthesia Network (PRAN): a multi-institutional study of the use and incidence of complications of pediatric regional anesthesia.

    abstract:BACKGROUND:Regional anesthesia is increasingly used in pediatric patients to provide postoperative analgesia and to supplement intraoperative anesthesia. The Pediatric Regional Anesthesia Network was formed to obtain highly audited data on practice patterns and complications and to facilitate collaborative research in ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,多中心研究

    doi:10.1213/ANE.0b013e31825d9f4b

    authors: Polaner DM,Taenzer AH,Walker BJ,Bosenberg A,Krane EJ,Suresh S,Wolf C,Martin LD

    更新日期:2012-12-01 00:00:00

  • The mechanism of helium-induced preconditioning: a direct role for nitric oxide in rabbits.

    abstract:BACKGROUND:Helium produces preconditioning against myocardial infarction by activating prosurvival signaling, but whether nitric oxide (NO) generated by endothelial NO synthase plays a role in this phenomenon is unknown. We tested the hypothesis that NO mediates helium-induced cardioprotection in vivo. METHODS:Rabbits...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ane.0b013e3181815995

    authors: Pagel PS,Krolikowski JG,Pratt PF Jr,Shim YH,Amour J,Warltier DC,Weihrauch D

    更新日期:2008-09-01 00:00:00

  • Patient characteristics and anesthetic technique are additive but not synergistic predictors of successful motor evoked potential monitoring.

    abstract:BACKGROUND:Spinal cord monitoring is associated with a significantly lower rate of neurologic deficits after deformity surgery, and has been shown to have predictive value in cervical, thoracic, and lumbar surgery. Lower extremity motor evoked potentials (MEPs) are particularly sensitive to anesthetics and physiologic ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ANE.0b013e3181e41804

    authors: Deiner SG,Kwatra SG,Lin HM,Weisz DJ

    更新日期:2010-08-01 00:00:00

  • Epidural morphine for the relief of postoperative pain after cesarean delivery.

    abstract::To determine the safety, efficacy, and dose response of epidurally administered morphine for analgesia after cesarean delivery, 40 healthy women who underwent cesarean delivery with epidural anesthesia were randomly assigned to receive one of four regimens for relief of postoperative pain: intramuscular administration...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:

    authors: Rosen MA,Hughes SC,Shnider SM,Abboud TK,Norton M,Dailey PA,Curtis JD

    更新日期:1983-07-01 00:00:00

  • Evidence for the Efficacy of Systemic Opioid-Sparing Analgesics in Pediatric Surgical Populations: A Systematic Review.

    abstract::While a large number of studies has examined the efficacy of opioid-sparing analgesics in adult surgical populations, fewer studies are available to guide postoperative pain treatment in pediatric patients. We systematically reviewed available publications on the use of systemic nonopioid agents for postoperative anal...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,评审

    doi:10.1213/ANE.0000000000002434

    authors: Zhu A,Benzon HA,Anderson TA

    更新日期:2017-11-01 00:00:00

  • Postoperative analgesia at home after ambulatory hand surgery: a controlled comparison of tramadol, metamizol, and paracetamol.

    abstract::We compared in a prospective, randomized, double-blinded study the analgesic efficacy of three drugs in 120 ASA I and II patients scheduled to undergo ambulatory hand surgery with IV regional anesthesia. At discharge, oral analgesic tablets were prescribed as follows: tramadol 100 mg every 6 h, metamizol 1 g every 6 h...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000539-200102000-00013

    authors: Rawal N,Allvin R,Amilon A,Ohlsson T,Hallén J

    更新日期:2001-02-01 00:00:00

  • A comparison of intrathecal plain solutions containing ropivacaine 20 or 15 mg versus bupivacaine 10 mg.

    abstract::Ropivacaine, which blocks sensory nerve fibers more readily than motor fibers, is considered to be less potent than bupivacaine. Our hypothesis was that, when used in spinal anesthesia for day surgery, ropivacaine 15 and 20 mg would provide faster motor recovery than bupivacaine 10 mg. This prospective, randomized, do...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1213/01.ANE.0000129976.26455.32

    authors: Kallio H,Snäll EV,Kero MP,Rosenberg PH

    更新日期:2004-09-01 00:00:00

  • Patient Blood Management: An International Perspective.

    abstract::This article describes practices in patient blood management (PBM) in 4 countries on different continents that may provide insights for anesthesiologists and other physicians working in global settings. The article has its foundation in the proceedings of a session at the 2014 AABB annual meeting during which internat...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,多中心研究

    doi:10.1213/ANE.0000000000001597

    authors: Eichbaum Q,Murphy M,Liu Y,Kajja I,Hajjar LA,Smit Sibinga CT,Shan H

    更新日期:2016-12-01 00:00:00

  • Target-Controlled Infusions: Paths to Approval.

    abstract::Target-controlled infusion of IV anesthetic drugs is approved worldwide with the exception of the United States. The purpose of this special article is to review regulatory pathways that could lead to target-controlled infusion (TCI) clearance or approval in the United States. ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,评审

    doi:10.1213/ANE.0000000000001018

    authors: Dryden PE

    更新日期:2016-01-01 00:00:00

  • The pain visual analog scale: is it linear or nonlinear?

    abstract:UNLABELLED:The visual analog scale (VAS) is a tool widely used to measure pain, yet controversy surrounds whether the VAS score is ratio or ordinal data. We studied 52 postoperative patients and measured their pain intensity using the VAS. We then asked them to consider different amounts of pain (conceptually twice as ...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章

    doi:10.1097/00000539-199912000-00038

    authors: Myles PS,Troedel S,Boquest M,Reeves M

    更新日期:1999-12-01 00:00:00

  • The ulinastatin-induced effect on neuromuscular block caused by vecuronium.

    abstract:UNLABELLED:We examined the effect of ulinastatin, a protease inhibitor purified from human urine, on neuromuscular block caused by vecuronium. Sixty adult patients were randomly divided into four groups of 15 patients each: ulinastatin-posttetanic count (U-PTC), ulinastatin-train-of-four (U-TOF), control-posttetanic co...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验,收录出版

    doi:10.1097/00000539-199912000-00048

    authors: Saitoh Y,Fujii Y,Oshima T

    更新日期:1999-12-01 00:00:00

  • Impact of an Analgesia-Based Sedation Protocol on Mechanically Ventilated Patients in a Medical Intensive Care Unit.

    abstract:BACKGROUND:Recent attention to adverse effects of intensive care unit (ICU) sedation has led to the use of strategies that target a "lighter" depth of sedation. Among these strategies are "analgosedation" protocols, which prioritize pain management and preferentially use IV opioids before administration of continuously...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ANE.0000000000001393

    authors: Faust AC,Rajan P,Sheperd LA,Alvarez CA,McCorstin P,Doebele RL

    更新日期:2016-10-01 00:00:00

  • Lumbar epidural blood patch to treat a large, symptomatic postsurgical cerebrospinal fluid leak of 5 weeks duration in a 3-year-old.

    abstract:UNLABELLED:A 3-yr-old with B-cell lymphoma presented with a 5-wk history of 400 mL/day cerebrospinal fluid (CSF) leak, which precluded chemotherapy, after placement of an Omaya reservoir and drain. Surgical repair was unsuccessful. Symptoms included irritability, failure to eat and noncommunication. After lumbar epidur...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/01.ane.0000100661.31566.43

    authors: Sanders JC,Gandhoke R,Moro M

    更新日期:2004-03-01 00:00:00

  • Time course of muscle relaxation with a combination of pancuronium and tubocurarine.

    abstract::A combination of pancuronium and d-tubocurarine is associated with potentiation of the neuromuscular blocking effects of each drug used singly. The time to onset of maximum block and the time to 25% recovery after administration of equipotent (ED95) doses of pancuronium (0.07 mg/kg) alone, d-tubocurarine (0.51 mg/kg) ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:

    authors: Mirakhur RK,Pandit SK,Ferres CJ,Gibson FM

    更新日期:1984-04-01 00:00:00

  • Effect of injection rate on level and duration of hypobaric spinal anesthesia.

    abstract::The purpose of this study was to determine whether injection rate affects the spread of hypobaric spinal anesthesia. Hypobaric spinal anesthesia was performed on 20 patients for total hip arthroplasty. Dural puncture was performed with a 22-gauge Whitacre needle. All patients received 10 mg of hypobaric tetracaine wit...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章

    doi:

    authors: Atchison SR,Wedel DJ,Wilson PR

    更新日期:1989-10-01 00:00:00

  • Oral ketamine/midazolam is superior to intramuscular meperidine, promethazine, and chlorpromazine for pediatric cardiac catheterization.

    abstract:UNLABELLED:An IM combination of meperidine, promethazine, and chlorpromazine (DPT) has been given as sedation for pediatric procedures for more than 40 years. We compared this IM combination to oral (PO) ketamine/midazolam in children having cardiac catheterization. A total of 51 children, ages 9 mo to 10 yr, were enro...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000539-200002000-00011

    authors: Auden SM,Sobczyk WL,Solinger RE,Goldsmith LJ

    更新日期:2000-02-01 00:00:00

  • The minimum alveolar anesthetic concentration of 2-, 3-, and 4-alcohols and ketones in rats: relevance to anesthetic mechanisms.

    abstract::The Meyer-Overton hypothesis predicts that anesthetic potency correlates inversely with lipophilicity; e.g., MAC times the olive oil/gas partition coefficient equals a constant of approximately 1.82 +/- 0.56 atm (mean +/- sd) for conventional inhaled anesthetics. MAC is the minimum alveolar concentration of anesthetic...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/01.ane.0000204258.00676.98

    authors: Won A,Oh I,Liao M,Sonner JM,Harris RA,Laster MJ,Brosnan R,Trudell JR,Eger EI 2nd

    更新日期:2006-05-01 00:00:00

  • Propofol does not ameliorate cerebral venous oxyhemoglobin desaturation during hypothermic cardiopulmonary bypass.

    abstract:UNLABELLED:Reductions in cerebral venous oxyhemoglobin saturation (SjO2) occur during the rewarming phase of hypothermic cardiopulmonary bypass (CPB). We prospectively investigated the effects of propofol on these reductions in SjO2 (SjO2 <50%). Fiberoptic jugular bulb catheters were inserted in 30 patients undergoing ...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000539-199805000-00002

    authors: Souter MJ,Andrews PJ,Alston RP

    更新日期:1998-05-01 00:00:00

  • A Contemporary Medicolegal Analysis of Outpatient Medication Management in Chronic Pain.

    abstract:BACKGROUND:Opioids are frequently used in chronic pain management but are associated with significant morbidity and mortality in some patient populations. An important avenue for identifying complications-including serious or rare complications-is the study of closed malpractice claims. The present study is intended to...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ANE.0000000000002499

    authors: Abrecht CR,Brovman EY,Greenberg P,Song E,Rathmell JP,Urman RD

    更新日期:2017-11-01 00:00:00

  • Intraoperative monitoring of tibialis anterior muscle motor evoked responses to transcranial electrical stimulation during partial neuromuscular blockade.

    abstract::We studied the feasibility of recording motor evoked responses to transcranial electrical stimulation (tce-MERs) during partial neuromuscular blockade (NMB). In 11 patients, compound muscle action potentials were recorded from the tibialis anterior muscle in response to transcranial electrical stimulation during vario...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/00000539-199210000-00021

    authors: Kalkman CJ,Drummond JC,Kennelly NA,Patel PM,Partridge BL

    更新日期:1992-10-01 00:00:00

  • A single adrenocorticotropic hormone stimulation test does not reveal adrenal insufficiency in septic shock.

    abstract::The diagnosis of adrenocortical insufficiency in critically ill patients is complex. The adrenocorticotropic hormone (ACTH) stimulation test is a widely accepted method for assessing the adequacy of adrenal function in intensive care units, but it is possible that there may be wide variations in responses to the test ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/01.ANE.0000184042.91452.48

    authors: Loisa P,Uusaro A,Ruokonen E

    更新日期:2005-12-01 00:00:00

  • A Cross-Sectional Survey to Determine the Prevalence of Burnout Syndrome Among Anesthesia Providers in Zambian Hospitals.

    abstract:BACKGROUND:Burnout is a psychological syndrome that results from chronic exposure to job stress. It is defined by a triad of emotional exhaustion, depersonalization, and reduced personal accomplishment. In research, mostly from high-income countries, burnout is common in health care professionals, especially in anesthe...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ANE.0000000000004464

    authors: Mumbwe MC,McIsaac D,Jarman A,Bould MD

    更新日期:2020-02-01 00:00:00