ABSTRACT
The laparoscopic cholecystectomy approach has become increasingly popular since it has been demonstrated to be a safe and reliable technique with several advantages over standard open technique. By using Thoracic electrical bioimpedance [TEB] in this study, we were able to measure the effects of anesthesia, pneumoperitoneum, and patient position on the hemodynamic profile over time. By the use of TEB, mean arterial blood pressure [MAP], heart rate [HR], cardiac index [CI] and stroke index [SI] were measured at nine points in time during laparoscopic cholecystectomy. 35 patients were encountered in this study. There were hemodynamic changes during the procedure. These changes were significant following anesthesia and CO2 insufflation. It gradually neutralized till reached normal levels after CO2 desufflation and by the end of procedure in the recovery room. Although it is a tremendous advance for patients, laparoscopic cholecystectomy can be associated with a significant reduction in cardiac output and blood pressure. Both surgeons and anesthesiologists must be alert to these changes. We propose careful hemodynamic monitoring during these procedures
Subject(s)
Humans , Male , Female , Hemodynamics , Heart Rate , Blood Pressure , Cardiac OutputABSTRACT
Percutaneous dilatation tracheostomy [PDT] is increasingly being used in the intensive care unit [ICU], and has probably increased the number of procedures performed. The primary aim of this study was to compare the percutaneous dilatation tracheostomy [PDT] with the traditional surgical tracheostomy [97] as regards ICU outcome. A prospective study was performed in the ICU. 46 patients were divided to undergo surgical tracheostomy [ST] or percutaneous dilatation tracheostomy [PDT]. Perioperative complications were recorded and analyzed. 21 patients underwent [ST] and 25 patients for [PDT]. There were no difference between the two groups in terms of age, sex, BMI, APACHE II score and baseline fractional inspired oxygen [FIO2]. The duration of the procedure and intubation days were significantly decreased in [PDT] group compared with [ST] group. Perioperative complications were significantly more in the [ST] group. The overall outcome was favorable with the [PDT] group compared with the [ST] group