ABSTRACT
Capnography is a useful technique in monitoring the integrity of anaesthetic equipment such as the malfunctioning of unidirectional valves in circle system. However, the lack of a precise mechanism in existing capnographs to identify the start of inspiration and the beginning of expiration in the capnograms, makes the analysis of the carbon dioxide waveforms during inspiration difficult and thus results in inaccurate assessment of rebreathing. We report a case where, during the malfunction of the inspiratory unidirectional valve in the circle system, the capnograph failed to detect the presence of substantial rebreathing. Critical analysis of the capnogram recorded during the malfunction revealed that there was substantial rebreathing which was underestimated by the capnograph as it reports only the lowest CO2 concentration rebreathed during inspiration in such abnormal situations.
Subject(s)
Anesthesia, Closed-Circuit/adverse effects , Anesthesia, Closed-Circuit/instrumentation , Carbon Dioxide/analysis , Monitoring, Physiologic/methods , Equipment Failure , Female , Humans , Inhalation , Middle Aged , Monitoring, Physiologic/instrumentation , Pressure , Pulmonary Ventilation/physiology , Respiration, Artificial , Tidal VolumeABSTRACT
Capnography is a useful technique in monitoring the integrity of anaesthetic equipment such as the malfunctioning of unidirectional valves in circle system. However, the lack of a precise mechanism in existing capnographs to identify the start of inspiration and the beginning of expiration in the capnograms, makes the analysis of the carbon dioxide waveforms during inspiration difficult and thus results in inaccurate assessement of rebreathing. We report a case where, during the malfunction of the inspiratory unidirectional valve in the circle system, the capnograph failed to detect the presence of substantial rebreathing. Critical analysis of the capnogram recorded during the malfunction revealed that there was substantial rebreathing which was underestimated by the capnograph as it reports only the lowest CO2 concentration rebreathed during inspiration in such abnormal situations.(AU)
Subject(s)
Humans , Middle Aged , Female , Anesthesia, Closed-Circuit/adverse effects , Anesthesia, Closed-Circuit/instrumentation , Carbon Dioxide/analysis , Monitoring, Physiologic/methods , Inhalation , Equipment Failure , Monitoring, Physiologic/instrumentation , Pressure , Respiration, Artificial , Pulmonary Ventilation/physiology , Tidal VolumeABSTRACT
Para determinar el comportamiento anestesico y las variaciones hemodinamicas del paciente geriatrico con la tecnica cuantitaviva, se realizo un estudio clinico, prospectivo y descriptivo, durante un lapso de 7 meses en el Servicio de Anestesia y Reanimacion del Hospital Universitario de Caldas, Facultad de Medicina de la Universidad de Caldas. A 72 pacientes mayores de 60 anos, de ambos sexos, clasificados ASA II-IV, programados para diversos tipos de cirugia, electiva y de urgencia, se le administro anestesia cuantitativa a bajos flujos, en un circuito cerrado, calculando la "dosis Unidad" sobre la Masa Metabolicamente Activa (MMA) con la formula propuesta por H. Lowe. El estudio no incluyo grupo control. El analisis de los casos comprendio patologia asociada, area quirurgica, preanestesia, agente inductor, drogas recibidas rutinariamente, estado de hidratacion, agente anestesico, relajante muscular, posicion del paciente, modificaciones hemodinamicas, tiempo en los cuales se presentaron estos cambios; tiempo quirurgico y tiempo de recuperacion. Los resultados fueron clasificados como satisfactorio (excelente, bueno) y NO satisfactorio (regular, malo). La evaluacion de la tecnica mostro un resultado satisfactorio en un 81.9% de los pacientes, no se encontro correlacion clinica ni estadistica en los resultados con la mayoria de las variables, excepto en el asocio del narcotico, usado para disminuir el MAC del agente anestesico, pues estos mostraron resultados no satisfactorios con significacion estadistica