Abstract:
BACKGROUND:One-lung ventilation (OLV) increases mechanical stress in the lung and affects ventilation and perfusion (V, Q). There are no data on the effects of OLV on postoperative V/Q matching. Thus, this controlled study evaluates the influence of OLV on V/Q distribution in a pig model using a gamma camera technique [single-photon emission computed tomography (SPECT)] and relates these findings to lung histopathology after OLV. METHODS:Eleven anaesthetized and ventilated pigs (V(T)=10 ml kg(-1), Fio2=0.40, PEEP=5 cm H2O) were studied. After lung separation, OLV and thoracotomy were performed in seven pigs (OLV group). During OLV and in a two-lung ventilation (TLV), control group (n=4) ventilation settings remained unchanged. SPECT with (81m)Kr (ventilation) and (99m)Tc-labelled macro-aggregated albumin (perfusion) was performed before, during, and 90 min after OLV/TLV. Finally, lung tissue samples were harvested and examined for alveolar damage. RESULTS:OLV affected ventilation and haemodynamic variables, but there were no differences between the OLV group and the control group before and after OLV/TLV. SPECT revealed an increase of perfusion in the dependent lung compared with baseline (49-56%), and a corresponding reduction of perfusion (51-44%) in non-dependent lungs after OLV. No perfusion changes were observed in the control group. This resulted in increased low V/Q regions and a shift of V/Q areas to 0.3-0.5 (10(-0.5)-10(-0.3)) in dependent lungs of OLV pigs and was associated with an increased diffuse alveolar damage score. CONCLUSIONS:OLV in pigs results in a substantial V/Q mismatch, hyperperfusion, and alveolar damage in the dependent lung and may thus contribute to gas exchange impairment after thoracic surgery.
journal_name
Br J Anaesthjournal_title
British journal of anaesthesiaauthors
Kozian A,Schilling T,Fredén F,Maripuu E,Röcken C,Strang C,Hachenberg T,Hedenstierna Gdoi
10.1093/bja/aen021subject
Has Abstractpub_date
2008-04-01 00:00:00pages
549-59issue
4eissn
0007-0912issn
1471-6771pii
S0007-0912(17)34376-3journal_volume
100pub_type
杂志文章abstract:BACKGROUND:Clonidine is a useful analgesic-sedative agent; however, few data exist regarding its use in infants after congenital heart disease surgery. We thus aimed to assess the absorption and safety of enterally administered clonidine in this setting. METHODS:Sixteen infants (median age 6.7 months) received a singl...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aeu258
更新日期:2014-12-01 00:00:00
abstract::The processed electroencephalogram (pEEG) was monitored in eight patients undergoing gynaecological laparotomy under combined extradural and nitrous oxide-isoflurane anaesthesia. Pre-incisional mean spectral edge frequency 95 percentile (SEF95) and median frequency (MF) were 11.67 (SD 1.63) Hz and 3.74 (0.24) Hz, resp...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/bja/78.6.751
更新日期:1997-06-01 00:00:00
abstract::In our daily anaesthetic practice, we are confronted with an increasing number of patients treated with either antiplatelet or anticoagulant agents. During the last decade, changes have occurred that make the handling of antithrombotic medication a challenging part of anaesthetic perioperative management. In this revi...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aew214
更新日期:2016-09-01 00:00:00
abstract::Cardiac rate and rhythm were compared in 60 patients having dental extractions under conventional general anaesthesia using halothane, enflurane or isoflurane to supplement nitrous oxide in oxygen. The incidence of arrhythmia was higher in the halothane group when compared with both the enflurane (P less than 0.05) an...
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/57.5.476
更新日期:1985-05-01 00:00:00
abstract::We have examined the effects of two types of insulin therapy (continuous i.v. infusion (group A: 1.25 u. h-1) and direct i.v. bolus administration of 10 u. every 2 h (group B: 10 u./2 h)) on the metabolic and endocrine responses to surgery in 60 adult diabetic patients undergoing general anaesthesia for elective proce...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/bja/72.1.5
更新日期:1994-01-01 00:00:00
abstract:BACKGROUND:Some patients have features that indicate possible difficulty with direct laryngoscopy for tracheal intubation. Prediction of the likely outcome and selection of patients for an enhanced management algorithm would reduce the possible harm from failed intubation attempts. METHODS:Adult elective patients were...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1016/j.bja.2018.09.021
更新日期:2019-02-01 00:00:00
abstract::Bupivacaine 2.5 mg kg-1 (0.5 ml kg-1 of 0.5% solution), with or without adrenaline 5 micrograms ml-1, was administered by interpleural injection to 12 patients after elective cholecystectomy. Noncompartmental analysis indicated that the addition of adrenaline had no effect on total body clearance, apparent volume of d...
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/64.6.662
更新日期:1990-06-01 00:00:00
abstract:BACKGROUND:We used an automated bispectral index (BIS)-guided dual-loop controller to determine propofol and remifentanil requirements during general anaesthesia in obese and lean surgical patients. METHODS:Obese patients, BMI>35 kg m(-2), and lean patients (<25 kg m(-2)) having laparoscopic procedures were prospectiv...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1093/bja/aeu401
更新日期:2015-04-01 00:00:00
abstract::One hundred years after Morton's demonstration of the anaesthetic effects of ether, T. Cecil Gray revolutionized anaesthesia with his introduction of balanced general anaesthesia. Gray's technique involved i.v. induction, administration of a neuromuscular blocking agent (curare), tracheal intubation, controlled ventil...
journal_title:British journal of anaesthesia
pub_type: 传,历史文章,杂志文章
doi:10.1093/bja/aer117
更新日期:2011-07-01 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:BACKGROUND:Miller laryngoscope blades are preferred for laryngoscopy in infants and children <2 yr of age. Despite their long history, the laryngeal view with the Miller blade size 1 has never been compared with that with the Macintosh (MAC) blade in children. This prospective, single-blinded, randomized study was desi...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aeu228
更新日期:2014-11-01 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::We have compared iontophoretically and locally applied lidocaine for relief of pain on propofol injection. Pain was assessed on insertion of a 20-gauge i.v. cannula and at 10-s intervals for 30 s after injection of propofol. Pain scores on cannulation were significantly less in the iontophoresis group (median 1.1) tha...
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/82.3.432
更新日期:1999-03-01 00:00:00
abstract::A double-blind randomized trial was conducted to compare etidocaine, the new local anaesthetic agent, with bupivacaine. One hundred patients were each given a single dose of one of the drugs during the surgical induction of labour. The results showed that etidocaine had a quicker onset of action than bupivacaine, but ...
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/47.12.1305
更新日期:1975-12-01 00:00:00
abstract::Using cats with chronically implanted brain electrodes, we have compared the effects of propofol on CNS electrical activities with those of thiopentone. Ten cats were allocated to receive either propofol (n = 5) or thiopentone (n = 5). Cats were anaesthetized initially with 4% halothane in oxygen. The trachea was intu...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/71.3.383
更新日期:1993-09-01 00:00:00
abstract:BACKGROUND:Infraclavicular axillary vein cannulation is not commonly used for central venous access because identifying the surface landmarks is difficult. Ultrasound guided axillary vein puncture has not been well described. We assessed ultrasound imaging to guide catheterization of the infraclavicular axillary vein. ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aeh187
更新日期:2004-08-01 00:00:00
abstract::The effects of the inhalation of 50% nitrous oxide on somatosensory evoked potentials during a fentanyl-oxygen anaesthetic technique for central nervous system surgery were evaluated. The latency and amplitude of the first cortical wave were obtained using conventional somatosensory techniques with median or posterior...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/57.9.849
更新日期:1985-09-01 00:00:00
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journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aew030
更新日期:2016-05-01 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
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journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/58.1.111
更新日期:1986-01-01 00:00:00
abstract::By analysing the EEG, reticular multi-unit activity and behavioural changes, we have classified general anaesthetics into three groups: central nervous system (CNS) depressant, CNS excitant and epileptogenic agents. Changes in CNS neural activity are associated with alteration in transmitter release. We have attempted...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/80.3.365
更新日期:1998-03-01 00:00:00
abstract::We have compared bupivacaine 5 mg ml-1, either isobaric in saline 0.9% or hyperbaric in 8% glucose, for spinal anaesthesia in 100 children, aged 2-115 months, in a double-blind, randomized, parallel group, prospective study. Children were premedicated with diazepam 0.5 mg kg-1 orally. Seventy-two children were sedated...
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/81.4.502
更新日期:1998-10-01 00:00:00
abstract:BACKGROUND:Circadian rhythms coordinate almost all physiological functions and are implicated in major disease development. Even though circadian rhythms have a major impact on human health, little is known about how they affect general anaesthesia. The purpose of this study was to understand if the time of day affects...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1016/j.bja.2018.06.027
更新日期:2018-10-01 00:00:00
abstract::In clinical use, the concentrations of local anaesthetics at the site of action are unknown. With the method described here, concentrations of local anaesthetics can be predetermined and kept constant at the site of action. In six volunteers, a blister was raised on the ventral surface of the forearm. After removal of...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/70.5.552
更新日期:1993-05-01 00:00:00
abstract::Before the induction of labour in 34 pregnant women 1.5% lignocaine 10 ml was injected into the lumbar extradural space at constant rates between 0.143 and 0.333 ml s-1. Injection pressures and residual pressures were recorded and the extent of analgesia to pinprick was assessed. No significant correlation was found b...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/52.1.55
更新日期:1980-01-01 00:00:00
abstract:BACKGROUND:The AirWay Scope (AWS) is a fibreoptic device that allows for intubation without alignment of the oral, pharyngeal, and tracheal axes. It may be useful for patients with an unstable cervical-spine (C-spine) or when C-spine movement is undesirable. This study was conducted to fluoroscopically evaluate upper C...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aen207
更新日期:2008-10-01 00:00:00
abstract::An histaminoid reaction after the administration of thiopentone and atracurium is described. Serial blood sampling showed no evidence of complement activation. Intradermal testing 6 weeks later yielded a positive result with atracurium (1 in 1000), but not with thiopentone. The clinical course of the reaction and the ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/57.8.811
更新日期:1985-08-01 00:00:00
abstract::Chinese hamster fibroblast cells in stirred suspension cultures were exposed to volatile anaesthetic agents for 3 hr or for 24 hr. Cell viability was measured as colony forming ability and was found to be reduced, in a dose related manner, by halothane, chloroform, methoxyflurane, trichloroetheylene and diethyl ether....
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/47.8.831
更新日期:1975-08-01 00:00:00
abstract:BACKGROUND:The ultrasound cardiac output monitor (USCOM) is a continuous wave Doppler system designed to measure cardiac output (CO) non-invasively and intermittently either from the pulmonary or from the aortic valve. USCOM scan quality is critical to obtaining reliable data and during anaesthesia it is said to deteri...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aet254
更新日期:2013-12-01 00:00:00
abstract::Respiratory mass spectrometry and on-line computation were used to estimate lung volume in normal subjects by a rebreathing technique, using oxygen, nitrogen and argon as indicators. The computation had previously been tested in a numerical model. In real normal lungs, it performed well enough for practical purposes, ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/56.5.509
更新日期:1984-05-01 00:00:00