Human cerebrovascular and ventilatory CO2reactivity to end-tidal, arterial and internal jugular veinPCO2

Abstract Objective To investigate whether laryngeal mask anesthesia had more favorable postoperative outcomes than double-lumen tube intubation anesthesia in uniportal thoracoscopic thymectomy. Methods Data were collected retrospectively from December 2013 to December 2017. A total of 96 patients with anterior mediastinum mass underwent nonintubated uniportal video-assisted thoracoscopic thymectomy with laryngeal mask, and 129 patients underwent intubated uniportal video-assisted thoracoscopic thymectomy. A single incision of ∼3 cm was made in an intercostal space along the anterior axillary line. Perioperative outcomes between nonintubated uniportal video-assisted thoracoscopic surgery (NU-VATS) and intubated uniportal video-assisted thoracoscopic surgery (IU-VATS) were compared. Results In both groups, incision size was kept to a minimum, with a median of 3 cm, and complete thymectomy was performed in all patients. Mean operative time was 61 minutes. The mean lowest SpO2 during operation was not significantly different. However, the mean peak end-tidal carbon dioxide in the NU-VATS group was higher than in the IU-VATS group. Mean chest tube duration in NU-VATS group was 1.9 days. Mean postoperative hospital stay was 2.5 days, with a range of 1 to 4 days. Time to oral fluid intake in the NU-VATS group was significantly less than in the IU-VATS group (p < 0.01). Several complications were significantly less in the NU-VATS group than in the IU-VATS group, including sore throat, nausea, irritable cough, and urinary retention. Conclusion Compared with intubated approach, nonintubated uniportal thoracoscopic thymectomy with laryngeal mask is feasible for anterior mediastinum lesion, and patients recovered faster with less complications.

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Association of Ventilation during Initial Trauma Resuscitation for Traumatic Brain Injury and Post-Traumatic Outcomes: A Systematic Review

Prehospital and Disaster Medicine ◽

10.1017/s1049023x21000534 ◽

2021 ◽

pp. 1-6

Author(s):

Mary Beth Howard ◽

Nichole McCollum ◽

Emily C. Alberto ◽

Hannah Kotler ◽

Mary E. Mottla ◽

...

Keyword(s):

Carbon Dioxide ◽

Systematic Review ◽

Traumatic Brain Injury ◽

Brain Injury ◽

Trauma Resuscitation ◽

Cerebral Herniation ◽

Full Text Review ◽

Post Traumatic ◽

Ventilation Strategies ◽

End Tidal

Abstract Objectives: In the absence of evidence of acute cerebral herniation, normal ventilation is recommended for patients with traumatic brain injury (TBI). Despite this recommendation, ventilation strategies vary during the initial management of patients with TBI and may impact outcome. The goal of this systematic review was to define the best evidence-based practice of ventilation management during the initial resuscitation period. Methods: A literature search of PubMed, CINAHL, and SCOPUS identified studies from 2009 through 2019 addressing the effects of ventilation during the initial post-trauma resuscitation on patient outcomes. Results: The initial search yielded 899 articles, from which 13 were relevant and selected for full-text review. Six of the 13 articles met the inclusion criteria, all of which reported on patients with TBI. Either end-tidal carbon dioxide (ETCO2) or partial pressure carbon dioxide (PCO2) were the independent variables associated with mortality. Decreased rates of mortality were reported in patients with normal PCO2 or ETCO2. Conclusions: Normoventilation, as measured by ETCO2 or PCO2, is associated with decreased mortality in patients with TBI. Preventing hyperventilation or hypoventilation in patients with TBI during the early resuscitation phase could improve outcome after TBI.

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Low intraoperative end-tidal carbon dioxide: a promising target to improve outcomes or a marker of physiologic instability?

Canadian Journal of Anesthesia/Journal canadien d anesthésie ◽

10.1007/s12630-021-02095-y ◽

2021 ◽

Author(s):

Susan M. Lee ◽

Perseus I. Missirlis

Keyword(s):

Carbon Dioxide ◽

Promising Target ◽

End Tidal Carbon Dioxide ◽

End Tidal

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Infantile Pyknocytosis: End-Tidal CO, %Micro-R Measurements, Next-Generation Sequencing, and Transfusion Avoidance with Darbepoetin

Biomedicine Hub ◽

10.1159/000511388 ◽

2020 ◽

Vol 5 (3) ◽

pp. 1-8

Author(s):

Timothy M. Bahr ◽

Mari C. Knudsen ◽

Michell Lozano-Chinga ◽

Archana M. Agarwal ◽

Jessica A. Meznarich ◽

...

Keyword(s):

Next Generation Sequencing ◽

Hemolytic Anemia ◽

Clinical Course ◽

Recombinant Erythropoietin ◽

Next Generation ◽

Good Outcome ◽

End Tidal ◽

Generation Sequencing

Infantile pyknocytosis is a rare, self-limited, hemolytic condition of unknown pathogenesis. It is diagnosed when a neonate with Coombs-negative hemolytic anemia has abundant pyknocytes and a characteristic clinical course after other hemolytic disorders has been excluded. Previous reports suggest that transfusions might be avoidable in this condition by administering recombinant erythropoietin. We cared for a patient with this disorder where we employed novel diagnostics and therapeutics. Despite these, and a good outcome free of transfusions, we continue to consider the condition to be idiopathic.

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