Abstract:
BACKGROUND:Airway pressure-release ventilation provides ventilation comparable to controlled mechanical ventilation (CMV), but with lower peak airway pressures and less dead-space ventilation. To obtain these advantages for patients administered general anesthesia, the authors (1) designed a mode similar to airway pressure-release ventilation, intermittent continuous positive airway pressure (CPAPI), and compared its efficiency with that of CMV; and (2) assessed the accuracy of end-tidal carbon dioxide tension (PETCO2) as a monitor of the partial pressure of carbon dioxide in arterial blood (PaCO2) during CPAPI compared with during CMV. METHODS:Twenty anesthetized, tracheally intubated patients received baseline CMV that produced a PETCO2 of approximately 35 mmHg and a pulse oximetry value > 90%. Patients were assigned to undergo alternating trials of CMV and CPAPI. During CPAPI, CPAP was applied to the airway, removed for 1 s, and reapplied at a rate equal to the ventilator rate during CMV. The difference between the carbon dioxide tension in arterial blood and end-tidal gas [P(a-ET)CO2] and the calculation of PaCO2/minute ventilation quantified the efficiency of ventilation. Data were summarized as mean +/- SD and compared using the Student's t-test. RESULTS:Peak airway pressure (13+/-2 vs. 23+/-5 cm H2O; P < 0.001) and minute ventilation (3.5+/-1 vs. 4.6+/-1.2 l/min; P < 0.0001) were lower during CPAPI than during CMV. The value for PaCO2/minute ventilation (11.1+/-2.9 vs. 7.9+/-2.6 mmHg x l(-1) x min(-1); P < 0.0001) was greater during CPAPI. P(a-ET)CO2 was always greater during CMV (6.3+/-1.6 vs. 1.7+/-0.9 mmHg; P < 0.0001) and was never > 3.5 mmHg during CPAPI. CONCLUSIONS:During CPAPI, less ventilation was necessary to produce a PaCO2 comparable to that during CMV. This represents a significant reduction in dead-space ventilation, improved efficiency of ventilation, and a lower value for P(a-ET)CO2. Compared with CMV, CPAPI also improves the accuracy of PETCO2 as a monitor of PaCO2.
journal_name
Anesthesiologyjournal_title
Anesthesiologyauthors
Bratzke E,Downs JB,Smith RAdoi
10.1097/00000542-199808000-00008subject
Has Abstractpub_date
1998-08-01 00:00:00pages
334-40issue
2eissn
0003-3022issn
1528-1175journal_volume
89pub_type
临床试验,杂志文章相关文献
ANESTHESIOLOGY文献大全abstract:BACKGROUND:Fluid resuscitation in hemorrhagic shock aims to restore hemodynamics and repair altered microcirculation. Hemodynamic coherence is the concordant performance of macro- and microcirculation. The present study on fluid therapy in hemorrhagic shock hypothesized that the choice of fluid (0.9% sodium chloride [s...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0000000000002998
更新日期:2020-01-01 00:00:00
abstract::To evaluate the effect of Bicitra (Willen Drug Company, Baltimore, Maryland), a commercial preparation of sodium citrate and metoclopramide, on gastric contents 150 elective outpatients allocated into six groups with 25 patients in each group were studied. Patients in Group 1 served as controls. Patients in Groups 2, ...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-198510000-00006
更新日期:1985-10-01 00:00:00
abstract:BACKGROUND:Residual paralysis increases the risk of pulmonary complications but is difficult to detect. To test the hypothesis that accelerometry predicts effects of residual paralysis on pulmonary and upper airway function, the authors related tests of pulmonary and pharyngeal function to accelerometry of adductor pol...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章
doi:10.1097/00000542-200306000-00006
更新日期:2003-06-01 00:00:00
abstract:BACKGROUND:Excessive bleeding often occurs during pediatric scoliosis surgery and is attributed to numerous factors, including accelerated fibrinolysis. The authors hypothesized that administration of tranexamic acid would reduce bleeding and transfusion requirements during scoliosis surgery. METHODS:Forty-four patien...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000542-200504000-00006
更新日期:2005-04-01 00:00:00
abstract:BACKGROUND:Amyloid deposition is a potential contributor to postoperative cognitive dysfunction. The authors hypothesized that 6-week global cortical amyloid burden, determined by F-florbetapir positron emission tomography, would be greater in those patients manifesting cognitive dysfunction at 6 weeks postoperatively....
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0000000000002103
更新日期:2018-04-01 00:00:00
abstract:BACKGROUND:Malignant hyperthermia is associated with mutations within the gene encoding the skeletal muscle ryanodine receptor, the calcium channel that releases Ca from sarcoplasmic reticulum stores triggering muscle contraction, and other metabolic activities. More than 200 variants have been identified in the ryanod...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0b013e3181d69283
更新日期:2010-06-01 00:00:00
abstract::Anesthetic exposure is usually necessary but rarely sufficient to the conduct of therapy. Consequently, there is a natural abhorrence of any worsening of a patient's condition secondary to the administration of anesthesia, which offers the patient no direct benefit. Highly safe anesthesia is a necessary precondition...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-197812000-00002
更新日期:1978-12-01 00:00:00
abstract:BACKGROUND:Use of high-dose inhalational anesthesia during open fetal surgery may induce maternal-fetal hemodynamic instability and fetal myocardial depression. The authors' preliminary human retrospective study demonstrated less fetal bradycardia and left ventricular systolic dysfunction with lower dose desflurane sup...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0b013e318283c954
更新日期:2013-04-01 00:00:00
abstract:BACKGROUND:The aim of this study was to determine whether progressive levels of hypothermia (37, 34, 31, or 28 degrees C) during cardiopulmonary bypass (CPB) in pigs reduce the physiologic and metabolic consequences of global cerebral ischemia. METHODS:Sagittal sinus and cortical microdialysis catheters were inserted ...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199802000-00018
更新日期:1998-02-01 00:00:00
abstract:BACKGROUND:Alveolar overdistension and repetitive derecruitment-recruitment contribute to ventilator-induced lung injury (VILI). The authors investigated (1) whether inflammatory cell activation due to VILI was assessable by positron emission tomography and (2) whether cell activation due to dynamic overdistension alon...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/01.anes.0000264748.86145.ac
更新日期:2007-04-01 00:00:00
abstract:BACKGROUND:It has been known that skeletal muscles show atrophic changes after prolonged sedation or general anesthesia. Whether these effects are due to anesthesia itself or disuse during anesthesia has not been fully clarified. Autophagy dysregulation has been implicated in muscle-wasting conditions. This study teste...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0000000000000561
更新日期:2015-05-01 00:00:00
abstract:BACKGROUND:Procedure times are important variables that often are included in studies of quality and efficiency. However, due to the need for costly chart review, most studies are limited to single-institution analyses. In this article, the authors describe how well the anesthesia claim from Medicare can estimate chart...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200702000-00024
更新日期:2007-02-01 00:00:00
abstract::Ketamine is used clinically as a racemic mixture of optical isomers that differ in their analgesic properties and psychomimetic effects. Administered individually, or together as the racemate, ketamine enantiomers differ in their hepatic clearance and duration of anesthetic effect. S(+) ketamine exhibits a greater cle...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199212000-00022
更新日期:1992-12-01 00:00:00
abstract:BACKGROUND:Blood pressure (BP) monitoring with arterial waveform display requires an arterial cannula. We evaluated a new noninvasive device, Vasotrac (Medwave, Arden Hills, MN) that provides BP measurements approximately every 12-15 beats and displays pulse rate and a calibrated arterial waveform for each BP measureme...
journal_title:Anesthesiology
pub_type: 杂志文章,多中心研究
doi:10.1097/00000542-199909000-00021
更新日期:1999-09-01 00:00:00
abstract:BACKGROUND:Awake tracheal intubation may evoke reflex bronchoconstriction in asthmatics. Whether this effect is altered by the choice of the local anesthetic used or by pretreatment with a beta2-adrenoceptor agonist is unknown. Therefore, we assessed the effect of awake fiberoptic intubation after lidocaine or dyclonin...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000542-200212000-00016
更新日期:2002-12-01 00:00:00
abstract:BACKGROUND:In vitro studies have shown that isoflurane, enflurane, and halothane inhibit the hypoxic pulmonary vasoconstriction (HPV) with essentially the same potency. The aim of this study is to compare the effects of sevoflurane and isoflurane on HPV in constant-flow perfused rabbit lungs. METHODS:Constant-flow per...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199312000-00026
更新日期:1993-12-01 00:00:00
abstract:BACKGROUND:Management of cardiovascular implantable electronic devices (CIEDs), including pacemakers and implantable cardioverter defibrillators, for surgical procedures is challenging due to the increasing number of patients with CIEDs and limited availability of trained providers. At the authors' institution, a small...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0000000000000838
更新日期:2015-11-01 00:00:00
abstract:BACKGROUND:The long-lasting high-affinity opioid buprenorphine has complex pharmacology, including ceiling effects with respect to analgesia and respiratory depression. Plasma concentrations of the major buprenorphine metabolites norbuprenorphine, buprenorphine-3-glucuronide, and norbuprenorphine-3-glucuronide approxim...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0b013e318238fea0
更新日期:2011-12-01 00:00:00
abstract:BACKGROUND:Human newborns, particularly those born before full term, are more susceptible to bacterial infections as a result of impaired host defense mechanisms. Compared with adults, circulating leukocytes from human newborns (preterm and full-term gestations) and newborn rabbits (full-term gestation) have low restin...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199702000-00017
更新日期:1997-02-01 00:00:00
abstract:BACKGROUND:An initial pilot study of 300 sub-Tenon local anesthetic blocks (STBs) for intraocular surgery established the effectiveness and patient acceptability of the technique. Following this, a decision was made in 1995 to change from sharp needle techniques to STB for all eye surgeries performed during local anest...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章
doi:10.1097/00000542-200304000-00025
更新日期:2003-04-01 00:00:00
abstract:BACKGROUND:Preoperative anemia is frequent in patients undergoing orthopedic surgery. The purpose of this study was to assess the preoperative increase of hemoglobin in iron deficiency anemia patients treated with intravenous iron. METHODS:After obtaining written informed consent, 20 patients with iron deficiency anem...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/01.anes.0000291441.10704.82
更新日期:2007-12-01 00:00:00
abstract:BACKGROUND:Cardiac preconditioning, including that induced by halogenated anesthetics, is an innate protective mechanism against ischemia-reperfusion injury. The adenosine triphosphate-sensitive potassium (K(ATP)) channels are considered essential in preconditioning mechanism. However, it is unclear whether K(ATP) chan...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200607000-00018
更新日期:2006-07-01 00:00:00
abstract:BACKGROUND:Optimal risk adjustment is a requisite precondition for monitoring quality of care and interpreting public reports of hospital outcomes. Current risk-adjustment measures have been criticized for including baseline variables that are difficult to obtain and inadequately adjusting for high-risk patients. The a...
journal_title:Anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/ALN.0b013e318219d5f9
更新日期:2011-06-01 00:00:00
abstract::Hemodynamic changes during four anesthetic techniques were studied in 80 preterm neonates. Atropine, 0.02 mg/kg, and pancuronium, 0.1 mg/kg, were given intravenously to all patients, who were ventilated with oxygen and air. Each group of 20 patients then received 0.75% isoflurane, 0.5% halothane, 20 micrograms/kg fent...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-198602000-00018
更新日期:1986-02-01 00:00:00
abstract:BACKGROUND:Early acquisition of critical competencies by novice anesthesiology residents is essential for patient safety, but traditional training methods may be insufficient. The purpose of this study was to determine the effectiveness of high-fidelity simulation training of novice residents in the initial management ...
journal_title:Anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/ALN.0b013e3181c62d43
更新日期:2010-01-01 00:00:00
abstract:BACKGROUND:The combining of epidural anesthesia with general anesthesia impairs central and peripheral thermoregulatory control and therefore is often accompanied by unintended intraoperative hypothermia. However, little is known about the cardiovascular response to hypothermia during combined epidural and general anes...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200104000-00023
更新日期:2001-04-01 00:00:00
abstract:BACKGROUND:The aim of this study was to generate a score based on preoperative characteristics and predictive of the individual probability of allogeneic erythrocyte transfusion in patients undergoing elective thoracolumbar spine surgery. METHODS:Two hundred thirty consecutive patients were retrospectively included ov...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0b013e31819df9e0
更新日期:2009-05-01 00:00:00
abstract::Critically ill patients must often breathe spontaneously through an endotracheal tube that acts as a fixed inspiratory and expiratory tubular airway resistor. Although this practice is common, its effect on the pattern of breathing is not known. The mean breathing patterns of seven normal, healthy male subjects and ei...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000542-198603000-00009
更新日期:1986-03-01 00:00:00
abstract::In the absence of data on the anatomic localization of the cuff of the laryngeal mask airway (LMA) in children, radiologic images were obtained from 50 infants and children (aged 1 month to 15 yr) undergoing diagnostic radiologic procedures during halothane and N2O:O2 anesthesia. In 46 patients, the cuff of the LMA wa...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199212000-00007
更新日期:1992-12-01 00:00:00
abstract:BACKGROUND:Few data support an association between blood pressure variability and clinical outcomes during cardiac surgery. We tested the hypothesis that intraoperative systolic blood pressure variability outside a targeted blood pressure range predicts 30-day mortality in patients undergoing cardiac surgery. METHODS:...
journal_title:Anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/ALN.0b013e3181e07ee9
更新日期:2010-08-01 00:00:00