Abstract:
BACKGROUND:Prolonged postoperative decrease in lung function is common after major upper abdominal surgery. Evidence suggests that ventilation with low tidal volumes may limit the damage during mechanical ventilation. We compared postoperative lung function of patients undergoing upper abdominal surgery, mechanically ventilated with high or low tidal volumes. METHODS:This was a double-blind, prospective, randomized controlled clinical trial. One hundred and one patients (age ≥ 50 yr, ASA ≥ II, duration of surgery ≥ 3 h) were ventilated with: (i) high [12 ml kg(-1) predicted body weight (PBW)] or (ii) low (6 ml kg(-1) PBW) tidal volumes intraoperatively. The positive end-expiratory pressure was 5 cm H(2)O in both groups and breathing frequency adjusted to normocapnia. Time-weighted averages (TWAs) of forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV(1)) until 120 h after operation were compared (P<0.025 considered statistically significant). Secondary outcomes were oxygenation, respiratory and non-respiratory complications, length of stay and mortality. RESULTS:The mean (sd) values of TWAs of FVC and FEV(1) were similar in both groups: FVC: 6 ml group 1.8 (0.7) litre vs 12 ml group 1.6 (0.5) litre (P=0.12); FEV(1): 6 ml group 1.4 (0.5) litre vs 12 ml group 1.2 (0.4) litre (P=0.15). FVC and FEV(1) at any single time point and secondary outcomes did not differ significantly between groups. CONCLUSIONS:Prolonged impaired lung function after major abdominal surgery is not ameliorated by low tidal volume ventilation.
journal_name
Br J Anaesthjournal_title
British journal of anaesthesiaauthors
Treschan TA,Kaisers W,Schaefer MS,Bastin B,Schmalz U,Wania V,Eisenberger CF,Saleh A,Weiss M,Schmitz A,Kienbaum P,Sessler DI,Pannen B,Beiderlinden Mdoi
10.1093/bja/aes140subject
Has Abstractpub_date
2012-08-01 00:00:00pages
263-71issue
2eissn
0007-0912issn
1471-6771pii
S0007-0912(17)32899-4journal_volume
109pub_type
杂志文章,随机对照试验abstract::Conventional extradural analgesia during labour with 0.25-0.375% bupivacaine may induce motor weakness and subjective sensory deficit, reducing maternal satisfaction. Even in a regimen for ambulatory extradural analgesia (0.1% bupivacaine-fentanyl 2 micrograms ml-1), a potential for proprioreception impairment exists,...
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/76.2.319
更新日期:1996-02-01 00:00:00
abstract::We report the extradural administration of low-dose morphine in 10 ml of 10% dextrose (2-3 mg) to 98 adult patients with various types of acute and chronic pain. Extradural morphine injections were given either via a Tuohy needle (single or repeat injection) or via an extradural catheter. Pain relief was evaluated by ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/52.3.247
更新日期:1980-03-01 00:00:00
abstract::We describe the perioperative management of a 31-yr-old primipara with Glanzmann's thrombasthenia, who required urgent Caesarean delivery at 33 weeks' gestation. Peripartum haemorrhage was inevitable and was pre-empted by transfusion of multiple blood products, the effects of which were monitored by Thrombelastograph....
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/88.5.734
更新日期:2002-05-01 00:00:00
abstract:BACKGROUND:Restrictive transfusion triggers are safe for most critically ill patients, but doubts exist for patients with ischaemic heart disease (IHD). We investigated the prevalence of reported IHD at admission to the intensive care unit (ICU) and investigated how this influenced red cell transfusion triggers. We als...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,多中心研究
doi:10.1093/bja/aei073
更新日期:2005-04-01 00:00:00
abstract::Although well established in clinical practice, both propofol and midazolam have limitations. New hypnotics with different and potentially superior pharmacokinetics and pharmacodynamics are under development. These include the benzodiazepine receptor agonists CNS7056 and JM-1232 (-), the etomidate-based methoxycarbony...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:10.1093/bja/aeq190
更新日期:2010-09-01 00:00:00
abstract:BACKGROUND:Postoperative non-cardiac complication rates are as high as 11-28% after high-risk abdominal procedures. Emerging evidence indicates that postoperative cardiac troponin T elevations are associated with adverse outcome in non-cardiac surgery. The aim of this study was to determine the relationship between pos...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/bja/aev027
更新日期:2015-06-01 00:00:00
abstract:BACKGROUND:Arterial cannulation is a common anaesthetic procedure that can be challenging and time-consuming in small children. By visualizing the position of the radial artery, near-infrared vascular imaging systems (NIRVISs) might be of assistance in arterial cannulation. The present study evaluates the effectiveness...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aes193
更新日期:2012-09-01 00:00:00
abstract:BACKGROUND:Transtracheal jet ventilation (TTJV) is recommended in several airway guidelines as a potentially life-saving procedure during the 'Can't Intubate Can't Oxygenate' (CICO) emergency. Some studies have questioned its effectiveness. METHODS:Our goal was to determine the complication rates of TTJV in the CICO e...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:10.1093/bja/aew192
更新日期:2016-09-01 00:00:00
abstract::Fires and explosions have occurred in the operating theatre for many years. Flammable inhalation anaesthetic agents were responsible for many incidents in the past, but these are no longer available in many countries. Other causes of fires and explosions still exist in the operating theatre and, from time to time, res...
journal_title:British journal of anaesthesia
pub_type: 历史文章,杂志文章
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更新日期:1994-12-01 00:00:00
abstract::Methodology for assessment of depth of anaesthesia based on analysis of the electroencephalogram (EEG) is controversial. Techniques range from display of single measures, for example median value of the frequency spectrum, to dedicated pattern recognition systems based on measures of several EEG features. We have comp...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/77.2.172
更新日期:1996-08-01 00:00:00
abstract:BACKGROUND:There is considerable evidence that the use of tidal volumes <6 ml kg(-1) predicted body weight (PBW) reduces mortality in mechanically ventilated patients. We evaluated the effectiveness of using a large screen displaying delivered tidal volume in ml kg(-1) (PBW) for reducing tidal volumes. METHODS:We asse...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aev110
更新日期:2015-08-01 00:00:00
abstract::Robotic surgery pushes the frontiers of innovation in healthcare technology towards improved clinical outcomes. We discuss the evolution to five generations of robotic surgical platforms including stereotactic, endoscopic, bioinspired, microbots on the millimetre scale, and the future development of autonomous systems...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:10.1093/bja/aex383
更新日期:2017-12-01 00:00:00
abstract:INTRODUCTION:Compared with term neonates, preterm babies are more likely to die from sepsis. However, the combined effects of sepsis and prematurity on neonatal postoperative mortality are largely unknown. Our objective was to quantify the proportion of neonatal postoperative mortality that is attributable to the syner...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,多中心研究
doi:10.1016/j.bja.2020.07.026
更新日期:2020-12-01 00:00:00
abstract::Following a paravertebral surgical incision, mature, female rats under ether anaesthesia were exposed to either 3% nitrous oxide, continuously for 48 h, or 50% nitrous oxide, 4 h each day for 7 days. For each exposure group, a similar number of rats was exposed to atmospheres containing no nitrous oxide. Wound healing...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/57.6.621
更新日期:1985-06-01 00:00:00
abstract:BACKGROUND:Pain on injection of propofol is unpleasant. We hypothesized that propofol infusion pain might be prevented by infusing remifentanil before starting the propofol infusion in a clinical setting where target-controlled infusions (TCI) of both drugs were used. A prospective, randomized, double-blind, placebo-co...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aem293
更新日期:2007-12-01 00:00:00
abstract:BACKGROUND:Cardiac output (CO) monitoring by uncalibrated arterial pressure waveform analysis (APCO) using the FloTrac/Vigileo™ is feasible in patients with intracranial haemorrhage, but the results of validation studies are contradictory. The aim of the present study was to analyse the clinical agreement between the i...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aer170
更新日期:2011-10-01 00:00:00
abstract:BACKGROUND:Desflurane at more than 1 minimum alveolar concentration (MAC) has been shown to prolong the QT interval, but it is unclear whether this is the case at lower concentrations. The aim of this study was to determine whether desflurane concentrations of <1 MAC affect tracheal intubation-induced prolongation of t...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aep355
更新日期:2010-02-01 00:00:00
abstract::We have compared the anaesthetic and analgesic efficacy of levobupivacaine with that of racemic bupivacaine in 66 male patients undergoing ambulatory primary inguinal herniorrhaphy. Patients were allocated randomly in a double-blind manner to local infiltration anaesthesia (0.25% w/v 50 ml) with either racemic bupivac...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1999-02-01 00:00:00
abstract::The trachea of a man who had cut his own throat was successfully intubated using a fibreoptic laryngoscope after attempts at conventional oral intubation had failed. The advantages of the fibreoptic instrument and the method of use in such an injury are discussed. ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/50.5.511
更新日期:1978-05-01 00:00:00
abstract::We have investigated the effect of volatile anaesthetics on protein synthesis and secretion in Hartley male guinea pig liver slices. The slices (250-300 microns thick) were incubated in sealed roller vials containing Krebs-Henseleit buffer at 37 degrees C under 95% oxygen. Volatile anaesthetics were vaporized in the v...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
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更新日期:1992-02-01 00:00:00
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journal_title:British journal of anaesthesia
pub_type: 杂志文章
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更新日期:1976-09-01 00:00:00
abstract::Twelve hydrocephalic patients undergoing hydrodynamic studies and shunt procedures during general anaesthesia were subjected to short term observations of the cerebrovascular effects of isoflurane. Intraventricular pressure (IVP), arterial pressure (AP); cerebral perfusion pressure (CPP = AP-IVP), end-tidal PCO2, Cere...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/59.10.1208
更新日期:1987-10-01 00:00:00
abstract::A high degree of safety from fires and explosions exists in operating theatres in the U.K. and this is reflected in the extremely low number of fatal and non-fatal accidents which occur. This has been achieved by safety precautions which in some respects have been over-careful and overexpensive. Antistatic precautions...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/50.7.659
更新日期:1978-07-01 00:00:00
abstract::Fentanyl or alfentanil, in doses approximating to those used in clinical practice, was added to the priming fluid of an extracorporeal circuit before the institution of cardiopulmonary bypass (CPB). The concentrations of both drugs in the priming fluid were measured over a 20-min period. The concentration of fentanyl ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/58.9.947
更新日期:1986-09-01 00:00:00
abstract::Intra-oral masses in neonates can seriously compromise the airway, potentially causing hypoxia and death if not recognized and managed appropriately. We report a case in which an intra-oral mass was diagnosed on antenatal ultrasound scan. Preparation for delivery involved a multidisciplinary team approach, with a stra...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/83.6.951
更新日期:1999-12-01 00:00:00
abstract:BACKGROUND:Priming during anaesthesia has been hard to replicate and the conditions under which it occurs remain poorly understood. We replicated and extended a recent study to determine whether intraoperative priming during propofol and nitrous oxide anaesthesia is a reliable phenomenon, whether it occurs due to aware...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:2005-01-01 00:00:00
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journal_title:British journal of anaesthesia
pub_type: 杂志文章
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更新日期:1982-04-01 00:00:00
abstract::We report a case of lumbar radiculopathy after zygapophyseal joint injections for chronic low back pain. The management of the patient and potential causes for the radiculopathy are discussed. The case acts as a reminder that the spinal nerve roots should be considered when performing intra-articular facet joint injec...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aem178
更新日期:2007-09-01 00:00:00
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 ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aen021
更新日期:2008-04-01 00:00:00
abstract::We have measured the onset and extent of the miotic effect of morphine and alfentanil in conscious patients. Forty unpremedicated ASA I and II patients were allocated randomly to four groups to receive either i.v. saline (control group), morphine 0.1 mg kg-1, alfentanil 4.0 micrograms kg-1 or a combination of these do...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1990-09-01 00:00:00