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1.
Intensive Care Med ; 17(7): 383-6, 1991.
Artigo em Inglês | MEDLINE | ID: mdl-1774390

RESUMO

Values obtained for cardiac output (CO) were compared using thermodilution (TD) with those obtained using bioimpedance (Bi) as measured using the Bomed NCCOM3 (Revision 6) in 28 consecutive patients in the first 24 h after coronary artery bypass surgery (CABS). In 46 paired measurements made in the first 12 h after CABS Bi values for CO were significantly lower than TD values, the limits of agreement between the two methods were also unacceptably large (mean Bi 4.38 (SD 1.40) l/min, mean TD 5.46 (SD 1.19) l/min, limits of agreement -3.05 to +0.89). In 55 paired measurements made after 12 h (all in spontaneously breathing patients) there was no significant difference between the two methods and acceptable limits of agreement, mean Bi 5.69 (SD 1.2) l/min mean TD 5.6 (SD 1.2) l/min, limits of agreement -0.99 to +1.17). The significantly lower BiCO values obtained in the first 12 h after CABS show that BiCO measurement is not consistently reliable in the intensive care setting.


Assuntos
Débito Cardíaco , Cardiografia de Impedância/normas , Ponte de Artéria Coronária , Monitorização Fisiológica/métodos , Termodiluição/normas , Viés , Cardiografia de Impedância/instrumentação , Estudos de Avaliação como Assunto , Humanos , Monitorização Fisiológica/instrumentação , Período Pós-Operatório , Reprodutibilidade dos Testes
2.
Intensive Crit Care Nurs ; 8(1): 40-6, 1992 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-1559023

RESUMO

The performance characteristics of two transcutaneous combined PO2 (tcPO2) and PCO2 (tcPCO2) sensors were compared with single tcPO2 and tcPCO2 electrodes in critically ill patients. The relationship between arterial blood gases (PaO2, PaCO2) and transcutaneous values was linear. Correlation coefficients (r) varied from 0.79 to 0.87 for tcPO2 and 0.92 to tcPCO2. The tcPO2 readings were always lower than PaO2 values, but the tcPCO2, with modified calibration of the electrodes, did not differ significantly from PaCO2. There was no significant difference of clinical importance in the performance of the three monitoring systems.


Assuntos
Monitorização Transcutânea dos Gases Sanguíneos , Dióxido de Carbono/sangue , Cuidados Críticos , Oxigênio/sangue , Adulto , Monitorização Transcutânea dos Gases Sanguíneos/instrumentação , Eletrodos , Humanos , Pressão Parcial , Polarografia , Valores de Referência
4.
Anaesthesia ; 36(3): 304-6, 1981 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-7224125

RESUMO

An injector gun of the type developed for vaccinations was used to perform intercostal nerve blocks. Analgesia was achieved in all patients to some degree, but the effectiveness of the technique was limited by the currently available local anaesthestics.


Assuntos
Nervos Intercostais , Bloqueio Nervoso/instrumentação , Nervos Torácicos , Bupivacaína/administração & dosagem , Epinefrina/administração & dosagem , Humanos , Injeções a Jato/instrumentação , Bloqueio Nervoso/métodos
5.
Anaesthesia ; 44(3): 235-7, 1989 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-2705611

RESUMO

A patient with obstructive sleep apnoea is described, who required admission to an intensive care unit on two separate occasions within 2 months. The first admission was after anaesthesia for operation on the upper airway. The second occurred after a relative overdose of an opioid analgesic was administered. The diagnosis, treatment and anaesthetic management of patients with this syndrome are discussed.


Assuntos
Síndromes da Apneia do Sono , Obstrução das Vias Respiratórias/complicações , Obstrução das Vias Respiratórias/cirurgia , Anestesia , Humanos , Pneumopatias Obstrutivas/complicações , Masculino , Pessoa de Meia-Idade , Cavidade Nasal/cirurgia , Fenazocina/efeitos adversos , Complicações Pós-Operatórias , Síndromes da Apneia do Sono/terapia
6.
Br J Anaesth ; 62(1): 95-7, 1989 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-2917117

RESUMO

The case is described of a patient with myasthenia gravis who required prolonged controlled ventilation for respiratory failure. Muscular relaxation was obtained with a continuous infusion of atracurium 5 mg h-1 for 45 h. Following cessation of the infusion, paralysis disappeared rapidly.


Assuntos
Atracúrio/administração & dosagem , Cuidados Críticos , Miastenia Gravis/complicações , Respiração Artificial , Insuficiência Respiratória/terapia , Adolescente , Feminino , Humanos , Unidades de Terapia Intensiva , Insuficiência Respiratória/etiologia , Fatores de Tempo
7.
Anaesthesia ; 47(4): 316-9, 1992 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-1519683

RESUMO

Two groups of 14 patients were compared after coronary artery bypass surgery where the left internal mammary artery had been used as a conduit. One group received nasal continuous positive airway pressure for 1 h, the other group acted as a control. Mean pulmonary shunt fraction was 16.3% before, 12.6% during and 15.7% after continuous positive airways pressure. In the control group the shunt fraction fell from 17.3% to 16.8%. The reduction in shunt fraction was significantly greater with nasal continuous positive airways pressure than in the control group (p = 0.016). There was a significant reduction (p = 0.025) in respiratory rate from 18.3 to 16.7 breath.min-1 during continuous positive airway pressure. Other measured cardiorespiratory variables did not differ significantly between the groups. Visual analogue scores showed no significant difference in chest pain or mask comfort between the groups. The ease of breathing score was, however, significantly better in the continuous positive airways pressure group, 7.5 (SD 1.8) cm and control 5.6 (SD 2.6) cm.


Assuntos
Ponte de Artéria Coronária , Respiração com Pressão Positiva , Cuidados Pós-Operatórios/instrumentação , Desenho de Equipamento , Hemodinâmica , Humanos , Masculino , Pessoa de Meia-Idade , Oxigênio/administração & dosagem , Satisfação do Paciente , Fumar
8.
Br J Anaesth ; 68(4): 349-51, 1992 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-1642911

RESUMO

Auditory evoked response (AER) was recorded before, during and after physiotherapy in 11 paralysed (atracurium 0.56 (SD) 0.13 mg kg-1 h-1), sedated (propofol 2.2 (1.0) mg kg-1 h-1; fentanyl 4.4 (2.3) micrograms kg-1 h-1) and critically ill patients undergoing ventilation in the intensive care unit (ICU). The latency of the negative wave, NB, was reduced by physiotherapy (mean 44.8 (SD) 7.9 ms before, 41.0 (6.8) ms during (P less than 0.01, non-parametric Friedman test) and 45.6 (6.3) ms after physiotherapy); NB amplitude showed no consistent change (-0.81 (1.4) microV, -0.81 (1.5) microV and -0.71 (1.3) microV, respectively). NB latency responded to patient arousal at constant levels of sedation and this requires further evaluation as a means of monitoring sedation in paralysed patients in the ICU.


Assuntos
Cuidados Críticos , Potenciais Evocados Auditivos/fisiologia , Paralisia/fisiopatologia , Modalidades de Fisioterapia , Adulto , Idoso , Nível de Alerta/fisiologia , Atracúrio , Estudos de Avaliação como Assunto , Feminino , Humanos , Hipnóticos e Sedativos , Masculino , Pessoa de Meia-Idade , Monitorização Fisiológica , Respiração Artificial
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