scholarly journals The Effect of Low- Flow Anesthesia on Hemodynamic Parameters and Gas Consumption in Single Lung Ventilation

2021 ◽  
Author(s):  
Fatih Doğu Geyik ◽  
Yucel Yuce ◽  
Kutlu Hakan Erkal ◽  
Banu Cevik ◽  
Kemal Tolga Saracoglu
Keyword(s):  
Lung Ventilation ◽  
Low Flow ◽  
Hemodynamic Parameters ◽  
Single Lung Ventilation ◽  
Gas Consumption ◽  
Low Flow Anesthesia

Low-Flow Anesthesia: Available Today???A Routine Tomorrow

1992 ◽  
Vol 36 (5) ◽  
pp. 334 ◽  
Author(s):  
OLA DALE ◽  
OLA STENQVIST
Keyword(s):  
Low Flow ◽  
Low Flow Anesthesia

Methods for Single-Lung Ventilation in Pediatric Patients

1999 ◽  
Vol 89 (6) ◽  
pp. 1426 ◽  
Author(s):  
Gregory B. Hammer ◽  
Brett G. Fitzmaurice ◽  
Jay B. Brodsky
Keyword(s):  
Pediatric Patients ◽  
Lung Ventilation ◽  
Single Lung Ventilation

scholarly journals Manajemen Low Flow Anesthesia pada Pasien Kraniosinostosis dengan Hipertelorisme yang menjalani Four Box Wall Osteotomy, dan Eksisi Redundant Skin Fronto Nasal

2021 ◽  
Vol 10 (3) ◽  
pp. 172-181
Author(s):  
Syarif Afif ◽  
◽  
Dewi Yulianti Bisri ◽  
M. Sofyan Harahap ◽  
Syafruddin Gaus ◽  
...  
Keyword(s):  
Fluid Management ◽  
Coagulation Factor ◽  
Massive Bleeding ◽  
Low Flow ◽  
First Year ◽  
Inhalation Anesthesia ◽  
Good Communication ◽  
Post Operative Pain ◽  
Low Flow Anesthesia ◽  
First Year Of Life

Craniosynostosis is a case that diagnosed in the first year of life and can need surgical in young age. Craniosynostosis is a part of hypertelorism with incidence rate around 20%. Boy, 13 years old with hypertelorism had undergone multiple surgery for correction of hypertelorism before. Patient was planned to advance surgical correction of four box wall osteotomy which consist frontal part correction and part of it is release craniosynostosis in coronal suture. Risk of massive bleeding because patient already in teen age and length of surgery can be prolonged. Difficult airway management due to fascial deformity, use of low flow anesthesia to preserve temperature and reduce inhalation anesthesia usage, intraoperative fluid management in consideration maintenance and replacement blood loss and post operative pain management has become another consideration. Covid-19 as part of problems post operatively being known before extubation made the process is delayed. Massive bleeding needs massive transfusion protocol to speed up blood availability. Blood product such as PRC, FFP and TC should be available because coagulation factor is part of consideration. Anesthesia management in hypertelorism with four box wall osteotomy need good communication between anesthesiologist, neurosurgeon, plastic surgeon and pediatric intensivist to reduce perioperative risk including covid-19 in pandemic era.

scholarly journals CURRENT POSSIBILITIES OF USE OF INDIRECT CALORIMETRY IN PERIOPERATIVE ENERGY MONITORING

2020 ◽  
Vol 2 (12) ◽  
pp. 79-89
Author(s):  
V.I. Cherniy ◽  
A.I. Denysenko
Keyword(s):  
Indirect Calorimetry ◽  
Lung Ventilation ◽  
International Standards ◽  
Low Flow ◽  
Narcotic Analgesics ◽  
Energy Monitoring ◽  
Perioperative Therapy ◽  
Surgical Interventions ◽  
Energy Equivalent ◽  
Arterial Blood

The purpose of the study is to develop a method of perioperative energy monitoring and to implement it in clinical practice. Material and methods. The study involved 125 patients who underwent various surgical interventions under general anesthesia using sevoflurane (inhalation anesthetics) and fentanyl (narcotic analgesics) in low-flow artificial lung ventilation. Methods of perioperative monitoring (International Standards for a Safe Practice of Anesthesia 2010, WFSA) were supplemented using indirect calorimetry. Results. Analyzing the literature data, a close correlation was found between the energy equivalent of oxygen (EEE2) and the respiratory factor (RQ). The authors obtained the corresponding one-factor linear regression formula, which had the form: EEE2 = 1.157 × RQ + 4,037. Using the basic principles of gas exchange in the lungs of Bohr-Engoff, a method of perioperative energy monitoring was developed, based on indirect calorimetry, taking into account the real values ​​of the energy equivalent of patients' oxygen. The universal formula for determining the level of metabolism of the patient (MR, cal / min) in the form of: MR = [0,863 × VE × (PECO2 / PaCO2) × (FiO2 - FeO2)] (1,157 × RQ + 4,037) where, VE - total ventilation of the lungs per minute (ml / min), PECO2, PaCO2 - partial pressure, respectively, in a mixture of gases, which is exhaled and in the arterial blood (mm Hg). FiO2 and FEO2 are the oxygen fraction in the gas mixture that is inhaled and exhaled in units (% / 100). The method is implemented as a computer program created on the basis of the developed formula. The methods of intensive perioperative therapy taking into account the level of metabolism are presented. Conclusion. The method of perioperative energy monitoring substantially complements the "International Standards for Safe Anesthesiology Practice", WFSA (2010) enhances the perioperative safety of patients by detecting metabolic disorders and conducting appropriate pathogenetic correction.

scholarly journals Venovenosus extrakorporális membránoxigenizációval (ECMO) végzett mellkassebészeti műtétek tapasztalatai Magyarországon. Retrospektív klinikai tanulmány

2019 ◽  
Vol 160 (42) ◽  
pp. 1655-1662
Author(s):  
Ildikó Madurka ◽  
Jenő Elek ◽  
Ákos Kocsis ◽  
László Agócs ◽  
Ferenc Rényi-Vámos
Keyword(s):  
Gas Exchange ◽  
Lung Resection ◽  
Lung Ventilation ◽  
Clinicopathological Characteristics ◽  
Morbidity And Mortality ◽  
Related Complication ◽  
Single Lung Ventilation ◽  
Perioperative Morbidity ◽  
Venovenous Ecmo ◽  
Vv Ecmo

Abstract: Introduction: Most modern thoracic operations are performed with single-lung ventilation balancing between convenient surgical approach and adequate gas exchange. The technical limitations include difficult airways or insufficient parenchyma for the intraoperative single-lung ventilation. Earlier, cardiopulmonary bypass was the only solution, however, today the extracorporeal membrane oxygenation is in the forefront. Aim: We retrospectively analysed our elective operations by use of venovenous ECMO to assess the indication, safety, perioperative morbidity and mortality. Patients and method: 12 patients were operated using venovenous (VV-) ECMO between 28 April 2014 and 30 April 2018 in the National Institute of Oncology. The main clinicopathological characteristics, data regarding the operation, the use of ECMO and survival were collected. Results: The mean age was 45 years, 2 patients had benign and 10 had malignant diseases. Extreme tracheal stricture was the indication for ECMO in 3 cases, while 4 patients had previous lung resection and lacked enough parenchyma for single-lung ventilation. 5 patients had both airway and parenchymal insufficiency. The average time of apnoea was 142 minutes without interruption in any of the cases. We did not experience any ECMO-related complication. We had no intraoperative death and 30-day mortality was 8.33%. Conclusion: In case of technical inoperability, when there is no airway or insufficient parenchyma for gas exchange, but pulmonary vascular bed is enough and there is no need for great-vessel resection, VV-ECMO can safely replace the complete gas exchange without further risk of bleeding. The use of VV-ECMO did not increase the perioperative morbidity and mortality. Previously inoperable patients can be operated with VV-ECMO. Orv Hetil. 2019; 160(42): 1655–1662.

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