scholarly journals Tatalaksana Bronkospasme selama Anestesi Umum

2020 ◽  
Vol 1 (3) ◽  
pp. 9-17
Author(s):  
Amalia Rahmadinie ◽  
◽  
Rudy Vitraludyono ◽  

Bronkospasme selama prosedur anestesi umum merupakan salah satu kejadian yang tidak diharapkan. Menurut beberapa literatur, etiologinya dapat disebabkan oleh proses anafilaksis, faktor mekanis, maupun farmakologis. Karakteristik utama dari bronkospasme adalah pemanjangan waktu ekspirasi, mengi, dan peningkatan peak airway pressure. Identifikasi dan penatalaksanaan segera dari bronkospasme selama anestesi umum harus dapat segera diketahui agar tidak menyebabkan hipoksia berkepanjangan, hipotensi, dan peningkatan angka morbiditas dan mortalitas. Penyebab utama dari bronkospasme harus diketahui segera selama penatalaksanaan yang dilakukan

2017 ◽  
Vol 30 (suppl 1) ◽  
pp. 241-248
Author(s):  
Rafael Vinícius Santos Cruz ◽  
Fabiana do Socorro da Silva Dias de Andrade ◽  
Pollyanna Dórea Gonzaga de Menezes ◽  
Bruno Oliveira Gonçalves ◽  
Robson da Silva Almeida ◽  
...  

Abstract Introduction: Although manual hyperinflation (MHI) is a physical therapy technique commonly used in intensive care and emergency units, there is little consensus about its use. Objective: To investigate the knowledge of physical therapists working in intensive care and emergency units about manual hyperinflation. Methods: Data were collected through self-administered questionnaires on manual hyperinflation. Data collection took place between September 2014 and January 2015, in Itabuna and Ilhéus, Bahia, Brazil. Results: The study sample was composed of 32 physical therapists who had between 4 months and 10 years working experience. All respondents affirmed that they used the technique in their professional practice. However, only 34.4% reported it to be a routine practice. 90.6% stated that the most common patient position during manual hyperinflation is “supine”. Participants were almost unanimous (93.8%) in citing secretion removal and cough stimulation as perceived benefits of MHI. High peak airway pressure was identified as being a precaution to treatment with MHI by 84.4% of participants, whilst 100% of the sample agreed that an undrained pneumothorax was a contraindication to MHI. Conclusion: The most common answers to the questionnaire were: supine position during MHI; secretion removal and cough stimulation as perceived benefits; high peak airway pressure as a precaution; and an undrained pneumothorax as a contraindication.


1970 ◽  
Vol 21 (1) ◽  
pp. 77-79
Author(s):  
ASM Moosa ◽  
M Baharul Islam ◽  
Shahina Akther ◽  
M Latifur Rahman ◽  
Nazim Uddin Ahmed

Laparoscopic surgical techniques are increasingly being applied to treat cholelithiasis and other indications of gallbladder diseases. These procedures however are not without potential morbidity. Herein we describe two patients treated with laparoscopic cholecystectomy; those cases were complicated with subcutaneous emphysema and hypercarbia per-operatively. After discontinuation of pneumoperitoneum, saturation of partial pressure of oxygen (SpO2) gradually increased with improvement of the neck subcutaneous emphysema, at the same time the lung ventilation also improved. Our findings show that we have to stop pneumoperitoneum or decrease partial pressure of end carbon dioxide level immediately, when we find a sudden increase of the peak airway pressure or decrease SpO2 with subcutaneous emphysema during laparoscopic cholecystectomy.   doi: 10.3329/taj.v21i1.3225 TAJ 2008; 21(1): 77-79


Author(s):  
Xiang Liu ◽  
Xiaona Tan ◽  
Qi Zhang ◽  
Li Qiao ◽  
Lei Shi

Abstract Objective An adequate intracuff pressure is important to ensure sufficient sealing function when using supraglottic airway devices to protect the airway from secretions and achieve adequate positive pressure ventilation. The aim of this study is to analyze a feasible and effective alternative Ambu AuraFlex intracuff pressure in child's laparoscopic surgery. Study Design Seventy-two children were included in this study. After insertion of the laryngeal mask airway AuraFlex, oropharyngeal leak pressure (OLP) was measured at intracuff pressures of 10, 30, and 60-cmH2O according to one of six sequences produced on the basis of 3 × 6 Williams crossover design. During the intraoperative period, AuraFlex was maintained using the last intracuff pressure of the allocated sequence. Oropharyngeal leak pressure, peak airway pressure, the fiberoptic view, mucosal change, and complications were assessed at three intracuff pressures. Results The OLP at the intracuff pressure of 10 cmH2O was significantly lower than that of 30 cmH2O (2# 18.1 ± 1.5 vs. 19.5 ± 1.4 cmH2O, p = 0.001; 2.5# 17.7 ± 1.2 vs. 20.2 ± 1.4, p = 0.001) and 60 cmH2O (2# 18.1 ± 1.5 vs. 20.0 ± 1.3 cmH2O, p = 0.002; 2.5# 17.7 ± 1.2 vs. 20.8 ± 1.1, p = 0.003). Compared with the peak airway pressure in pre-and postpneumoperitoneum, the OLP was significantly higher. Subgroup analysis showed no differences in mucosal change and complications. Conclusion Intracuff pressures of 30 may be sufficient for the Ambu AuraFlex in child's laparoscopic surgery, and there may be no added benefit of an intracuff pressure of 60 cmH2O, as oropharyngeal leak pressures were similar.


1985 ◽  
Vol 58 (5) ◽  
pp. 1616-1621 ◽  
Author(s):  
K. J. Killian ◽  
E. Summers ◽  
M. Basalygo ◽  
E. J. Campbell

Using open-magnitude scaling, six normal subjects estimated the perceived magnitude of a range of added elastic loads (20–76 cmH2O/l), applied for a sequence of five breaths, at frequencies varying from 5 to 26.4 breaths/min. Two experiments were performed. In the first, frequency was increased by a reduction in expiratory duration (TE), and the duty cycle (ratio of inspiratory duration to total breath duration, TI/TT) ranged between 0.10 and 0.52. The perceived magnitude psi increased significantly with the peak airway pressure (Pm) (P less than 0.0001) but did not reach conventional significance with frequency (fb) (P = 0.15): psi = K0Pm1.23fb0.07 (r = 0.911). However, the sensory magnitude increased significantly as the duty cycle increased (P less than 0.01), but when it was included, the magnitude decreased minimally with frequency (P less than 0.01): psi = K0Pm1.3fb-0.97 TI/TT1.14 (r = 0.92). In the second experiment the duty cycle (TI/TT) was kept constant [(0.43 +/- 0.008 (SE)] and frequency (5–26.4 breaths/min) increased at the expense of shortening both TI and TE. The perceived magnitude of the added elastances decreased with the increase in frequency. However, when the perceived magnitude was corrected for the duration of inspiration, which is known to increase the sensory magnitude, psi = K0Pm1.3TI0.56, the sensory magnitude increased significantly with frequency (P less than 0.001): psi/TI0.56 = K0Pm1.21fb0.28 (r = 0.773). The decrease in inspiratory duration had a greater quantitative effect decreasing sensory magnitude than frequency had on increasing the magnitude. The effect of increasing frequency is complex and depends on the simultaneous intensity, duration of inspiratory pressure, and the duty cycle.


2012 ◽  
Vol 12 (9) ◽  
pp. S126-S127
Author(s):  
Ernest Y. Young ◽  
Navkirat Bajwa ◽  
Nicholas U. Ahn

1997 ◽  
Vol XLI (3) ◽  
pp. 184
Author(s):  
DOMINIQUE CHASSARD ◽  
KHALID BERRADA ◽  
JEAN-PIERRE TOURNADRE ◽  
PAUL BOUL??TREAU

2017 ◽  
Vol 2 (1) ◽  
Author(s):  
Anna Fiala ◽  
Ruth Kroess ◽  
Sabrina Neururer ◽  
Patrick Braun ◽  
Nicole Nachbar ◽  
...  

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