Abstract:
BACKGROUND:The objective of this study was to determine the intracranial, cardiovascular and respiratory changes induced by conversion to high-frequency oscillator ventilation from conventional mechanical ventilation at increasing airway pressures. METHODS:In this study, 11 anaesthetized sheep had invasive cardiovascular and intracranial monitors placed. Lung injury was induced by saline lavage and head injury was induced by inflation of an intracranial balloon catheter. All animals were sequentially converted from conventional mechanical ventilation to high-frequency oscillator ventilation at target mean airway pressures of 16, 22, 28, 34 and 40 cm H(2)O. The mean airway pressure was achieved by adjusting positive end expiratory pressure while on conventional mechanical ventilation, and continuous distending pressures while on high-frequency oscillator ventilation. Cerebral lactate production, oxygen consumption and venous oximetry were measured and analysed in relation to changes in transcranial Doppler flow velocity. Transcranial Doppler profiles together with other physiological parameters were measured at each airway pressure. RESULTS:Cerebral perfusion pressure was significantly lower during high-frequency oscillator ventilation than during conventional mechanical ventilation (CMV: 45, 34, 22, 6, 9 mmHg vs. HFOV: 33, 20, 19, 5, 5 mmHg at airway pressures mentioned above, P = 0.02). Intracranial pressure and cerebrovascular resistance increased with increasing intrathoracic pressures (P = 0.001). Cerebral metabolic indices demonstrated an initial increase in anaerobic metabolism followed by a decrease in cerebral oxygen consumption progressing to cerebral infarction as intrathoracic pressures were further increased in a stepwise fashion. Arterial PaCO(2) increased significantly after converting from conventional mechanical ventilation to high-frequency oscillator ventilation (P = 0.001). However, no difference was observed between conventional mechanical ventilation and high-frequency oscillator ventilation when intracranial pressure, metabolic and transcranial Doppler indices were compared at equivalent mean airway pressures. CONCLUSIONS:The use of high positive end expiratory pressure with conventional mechanical ventilation or high continuous distending pressure with high-frequency oscillator ventilation increased intracranial pressure and adversely affected cerebral metabolic indices in this ovine model. Transcranial Doppler is a useful adjunct to intracranial pressure and intracranial venous saturation monitoring when major changes in ventilation strategy are adopted.
journal_name
Eur J Anaesthesioljournal_title
European journal of anaesthesiologyauthors
O'Rourke J,Sheeran P,Heaney M,Talbot R,Geraghty M,Costello J,McDonnell C,Newell J,Mannion Ddoi
10.1017/S0265021506002006subject
Has Abstractpub_date
2007-05-01 00:00:00pages
454-63issue
5eissn
0265-0215issn
1365-2346pii
S0265021506002006journal_volume
24pub_type
杂志文章abstract::A 72-year-old woman had a minitracheostomy inserted for sputum retention. This was undertaken by a relatively junior resident who opted to use an early model minitracheostomy kit Minitrach II. The following day the patients condition deteriorated and intubation was warranted, at which time it was apparent to senior st...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1046/j.1365-2346.1999.00530.x
更新日期:1999-08-01 00:00:00
abstract:BACKGROUND:Patient blood management (PBM) can prevent preoperative anaemia, but little is known about practice in Europe. OBJECTIVE:To assess the pre and postoperative prevalence and perioperative management of anaemia in patients undergoing elective orthopaedic surgery in Europe. DESIGN:An observational study; data ...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,多中心研究
doi:10.1097/EJA.0000000000000202
更新日期:2015-03-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:In isolated-perfused lungs of lipopolysaccharide (LPS)-challenged rats, vasodilatation to inhaled nitric oxide (NO) is impaired. Inhibition of nitric oxide synthase 2 (NOS2) by aminoguanidine (AG) prevented hyporesponsiveness to inhaled NO. Here, we investigated whether NOS2-mediated nitrite/n...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1017/S0265021506001463
更新日期:2007-04-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:A variable incidence rate of renal dysfunction (3-35%) after cardiac surgery with cardiopulmonary bypass has been reported. The aim was to define the typical pattern of renal dysfunction that follows coronary surgery with cardiopulmonary bypass using albumin, immunoglobulin (IgG), alpha1-microg...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1017/s0265021503000693
更新日期:2003-06-01 00:00:00
abstract::Survey results continue to reveal that postoperative pain is insufficiently managed throughout Europe and the rest of the world. However, the efficient use of existing resources, as well as the introduction of novel technologies, may aid in its improvement. Use of an acute pain service has the potential to improve pai...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,评审
doi:10.1017/S026502150600189X
更新日期:2007-04-01 00:00:00
abstract::In a randomized, double-blind study, we administered placebo and diclofenac sodium 100 mg suppositories 1 h pre-operatively and on the first post-operative morning to 22 adult patients undergoing minor orthopaedic surgery. A standardized post-operative intravenous fluid regimen was instituted until oral fluids were to...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1995-07-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Isoflurane has been shown experimentally to protect the myocardium against infarction but the clinical relevance of these findings is not yet well established. We therefore evaluated the effects of isoflurane administration before cardiopulmonary bypass (CPB) on postoperative cardiac troponin I...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1017/s0265021504009044
更新日期:2004-09-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Preoperative oral dextromethorphan and intravenous clonidine attenuate arterial pressure and heart rate increases during tourniquet inflation under general anaesthesia. The effect of preoperative oral clonidine on these variables has not been investigated. METHODS:We designed this study to com...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1017/S0265021506002055
更新日期:2007-06-01 00:00:00
abstract:BACKGROUND:Postoperative cognitive dysfunction (POCD) may be related to the systemic inflammatory response and an increase in serum markers of brain injury such as S100B protein and neuron-specific enolase (NSE). OBJECTIVE:The study aims to evaluate the association between POCD and serum levels of S100B and NSE after ...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1097/EJA.0000000000000450
更新日期:2016-09-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:The glutamate-nitric oxide-cyclic guanosine monophosphate pathway has been identified as a potential target for anaesthetic agents. However, mice deficient in neuronal nitric oxide synthase have a similar susceptibility to volatile anaesthetic agents to wild-type mice and are not affected by no...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1017/S0265021505002188
更新日期:2006-03-01 00:00:00
abstract:BACKGROUND:Neuromuscular blockade (NMB) monitoring is essential to avoid residual NMB. While the adductor pollicis is the recommended site for monitoring recovery, it is not always accessible. The flexor hallucis brevis could be an interesting alternative. OBJECTIVE:The aim of our study was to compare NMB onset and re...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1097/EJA.0000000000001090
更新日期:2020-01-01 00:00:00
abstract:BACKGROUND:Pre-operative anaemia is associated with adverse outcomes of noncardiac surgery, but its association with myocardial injury after noncardiac surgery (MINS) has not been fully investigated. OBJECTIVE:The association between pre-operative anaemia and MINS. DESIGN:A single-centre retrospective cohort study. ...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1097/EJA.0000000000001421
更新日期:2021-01-04 00:00:00
abstract::Diazepam premedication decreases the overall metabolic rate and oxygen consumption. Whether its properties are shared by midazolam is not known. In this study, eight healthy male volunteers were given oral diazepam (10 mg), midazolam (15 mg) and placebo in a random double-blind cross-over fashion. Metabolic responses ...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1994-09-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:To know whether the application of patient-controlled analgesia devices could be avoided if intrathecal morphine is given in combination with spinal anaesthesia. METHODS:In a randomized, double-blind multicentre study, 188 orthopaedic patients were randomized to receive intrathecally placebo, ...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1097/EJA.0b013e328329b045
更新日期:2009-08-01 00:00:00
abstract::Cardiovascular and hormonal responses to reconstructive abdominal aortic surgery were studied in 20 patients anaesthetized either with moderate-dose fentanyl (20 micrograms kg-1) combined with isoflurane, nitrous oxide and oxygen (n = 10), or with thoracolumbar epidural bupivacaine combined with isoflurane, nitrous ox...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1991-11-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:We assessed the analgesic efficacy of postoperative epidural infusions of ropivacaine 0.1 and 0.2% combined with sufentanil 1 microg mL(-1) in a prospective, randomized, double-blinded study. METHODS:Twenty-two ASA I-III patients undergoing elective total-knee replacement were included. Lumbar...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1017/s0265021502001096
更新日期:2002-09-01 00:00:00
abstract::Intrathecal midazolam for use as a post-operative analgesic when given alone and in conjunction with intrathecal diamorphine was assessed. Fifty-two patients scheduled for elective Caesarean section under spinal anaesthesia were randomly allocated to receive either bupivacaine (B), bupivacaine with diamorphine (BD), b...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1046/j.1365-2346.1996.00044.x
更新日期:1996-11-01 00:00:00
abstract:BACKGROUND:Postoperative shivering is one of the most common complications in patients recovering from general anaesthesia. Although a variety of pharmacological therapies have been used to control postoperative shivering, no ideal drug has been found to date. OBJECTIVES:The aim of this study was to compare the effica...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/01.EJA.0000436684.94403.1e
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journal_title:European journal of anaesthesiology
pub_type: 杂志文章,评审
doi:10.1046/j.1365-2346.1996.00939.x
更新日期:1996-03-01 00:00:00
abstract:BACKGROUND:Isoflurane has shown better control of intensive care sedation than propofol or midazolam and seems to be a useful alternative. However, its effect on survival remains unclear. OBJECTIVE:The objective of this study is to compare mortality after sedation with either isoflurane or propofol/midazolam. DESIGN:...
journal_title:European journal of anaesthesiology
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更新日期:2016-01-01 00:00:00
abstract::Patients about to undergo a suspension laryngoscopy were randomly assigned to one of two groups (n = 10). They were given either etomidate 1 mg kg-1 followed by 1 mg kg-1 h-1, or propofol 2.5 mg kg-1 followed by 9 mg kg-1 h-1. Alfentanil 10 micrograms kg-1 was given to provide analgesia with a further half dose if nec...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1991-03-01 00:00:00
abstract::The airway was managed successfully in two cases of difficult intubation using the Combitube, a new device for emergency intubation, which combines the functions of an oesophageal obturator airway and a conventional endotracheal airway. One patient could not be intubated due to lockjaw; in the other patient, the vocal...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:
更新日期:1995-03-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Bleeding after cardiac surgery correlates with morbidity and mortality. The aim of this study was to determine the influence of antiplatelet therapy on bleeding and transfusion rates in coronary artery bypass grafting. METHODS:Forty patients receiving aspirin and/or clopidogrel/ticlopidine wit...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1017/S0265021506002262
更新日期:2007-04-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:The perception of a looming manpower shortage led the French College of Anaesthesiologists (CFAR) and the French Society of Anaesthesia and Intensive Care (SFAR), with assistance from the National Institute for Demographic Studies (INED), to conduct a national survey of French anaesthesiologist...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1017/s0265021504005095
更新日期:2004-05-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Administration of calcium safely and effectively reverses many of the electrophysiological actions of hyperkalaemia, but it has not been studied for pretreatment. Based on cellular studies, magnesium also has been suggested to prevent the effects of potassium on the heart. As their mechanisms o...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1017/s0265021503000978
更新日期:2003-08-01 00:00:00
abstract::The anti-emetic effects of ondansetron and droperidol were evaluated in 134 ASA Grade I and II female patients, scheduled for laparoscopic cholecystectomy and minor gynaecological laparoscopic surgery, who were randomly assigned to receive ondansetron 4 mg or droperidol 75 micrograms kg-1 intravenously immediately aft...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1046/j.1365-2346.1999.00581.x
更新日期:1999-11-01 00:00:00
abstract::Two patients presented with very different signs of central anticholinergic syndrome following general anaesthesia for which they had received premedication with hyoscine. Both responded dramatically to 1 mg of intravenous (i.v.) physostigmine, which produced a rapid return to a normal level of consciousness. The aeti...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1046/j.1365-2346.1997.00128.x
更新日期:1997-07-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:The elderly represent a wide and increasing patient population and significant numbers of elderly patients have chronic renal disease. This study aimed to investigate the neuromuscular effects of 0.6 mg kg(-1) rocuronium under propofol anaesthesia in young adults and elderly patients with or w...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1017/S0265021508004717
更新日期:2008-11-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:The study compared the analgesic efficacy and safety of two preoperatively administered cyclo-oxygenase-2 inhibitors, celecoxib and rofecoxib. METHODS:Ninety adult patients undergoing thyroid surgery were divided into three groups (each n = 30). They were given a single oral dose of placebo, c...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1017/s0265021503000796
更新日期:2003-06-01 00:00:00
abstract::The effects of protamine (6 mg kg-1) injected after heparin (5 mg kg-1) have been studied in five groups of five New Zealand white rabbits. Group I was treated with the sequence heparin-protamine and group II with protamine alone. The animals of groups III and IV received respectively intravenous indomethacin (3 mg kg...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:
更新日期:1992-07-01 00:00:00