摘要:

Oxygen consumption (&OV0312;O2) measured by indirect calorimetry (Nellcor-Puritan-Bennett 7250; Carlsbad, CA, USA) has been compared with&OV0312;O2calculated by the Fick method in 22 volume-controlled ventilated general surgical patients in the early post-operative period. For 198 pairs of measurements,&OV0312;O2Fick and&OV0312;O2indirect calorimetry correlated significantly (y=1.00x−35.8,P=0.0001,r=0.77).&OV0312;O2indirect calorimetry was 212 ± 32 mL min−1and&OV0312;O2Fick was 177 ± 41 mL min−1(P=0.0001). The bias was 35 ± 26 mL min−1. This difference represents 16 ± 13% of the total body&OV0312;O2.&OV0312;O2calculated by the Fick method did not accurately predict&OV0312;O2measured by indirect calorimetry, and the two methods were not interchangeable.&OV0312;O2calculated by the Fick method underestimated&OV0312;O2as measured by indirect calorimetry by a systematic quantity that could be attributed, in part, to&OV0312;O2of the lung. Indirect calorimetry should be the preferred method for measuring total body&OV0312;O2in mechanically ventilated surgical patients.

ISSN:0265-0215    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

This study was undertaken to determine the minimum effective dose of granisetron, 5-hydroxytryptamine type 3 receptor antagonist, for the prevention of post-operative vomiting in children undergoing general inhalational anaesthesia for surgery (inguinal hernia and phimosis). In a randomized, double-blind manner, 120 children, ASA physical status I, aged 4-10 years, were assigned to receive placebo (saline) or granisetron at three different doses (20 μg kg−1, 40 μg kg−1, 100 μg kg−1) intravenously immediately after inhalation induction of anaesthesia (n=30 of each). A complete response, defined as no emesis and no need for another rescue antiemetic during the first 24 h after anaesthesia, occurred in 57% with placebo, 67% with granisetron 20 μg kg−1, 90% with granisetron 40 μg kg−1and 90% with granisetron 100 μg kg−1respectively (P<0.05; overall Fisher's exact probability test). No clinically important adverse events were observed in any of the groups. Our results suggest that granisetron 40 μg kg−1is the minimum effective dose for the prevention of emesis after paediatric surgery, and that increasing its dose to 100 μg kg−1provides no demonstrable benefit.

ISSN:0265-0215    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Patients treated with bleomycin (BLM) are at risk of developing acute respiratory distress syndrome (ARDS) post-operatively, and this has been associated with high intraoperative concentrations of oxygen. We report progressive arterial desaturation noticeable 2 h after the start of a 4-h radical neck dissection for which the anaesthesia included 50% O2in N2O. The patient had received two courses of bleomycin within the previous 2 months and had undergone an uneventful right hemiglossectomy under shorter but otherwise similar anaesthesia 4 weeks previously. His pulmonary function tests before the second procedure showed a slight depression of diffusing capacity (DLco) to 80% of predicted and minimal airway obstruction consistent with his history of smoking. The pulse oximetric reading during his second procedure reached 75%, but rose to 95% after treatment with methylprednisolone, salbutamol and inspired O2concentrations between 80% and 100%. By the end of the procedure, he satisfied the criteria for ARDS and was transferred to the ICU, where he developed bilateral pneumonia, deteriorated and died of multiple organ failure. This case suggests that the risk of hyperoxic pulmonary damage in patients exposed to bleomycin may increase not only with the degree and duration of hyperoxia in a given exposure, but also with the latent effects of recent previous exposure. Near normality of pulmonary function tests cannot be taken as reassurance, and small changes may have more adverse prognostic significance than in patients who have not been exposed to bleomycin.

ISSN:0265-0215    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Complication during a drum catheter placement via an antecubital fossa vein is presented.

ISSN:0265-0215    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:0265-0215    

出版商:OVID    

年代:1999

数据来源: OVID