| Guie Young Lee | 6 Articles |
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[English]
No abstract available in English. Citations Citations to this article as recorded by
[English]
It is well known that changes in end-tidal carbon dioxide partial pressure (PETCO2) can reflect changes in cardiac output during cardiopulmonary resuscitation. The present study was performed to evaluate quantitative relationship between the changes in PETCO2 and cardiac output in the acute hemorrahagic dogs. Six anesthetized(isoflurane 1.0%), paralyzed, and mechanically constant ventilated dogs submitted to hemorrhage were studied. The dogs were hemorrhaged by progressive withdrawal of 50% of blood volume. After withdrawal of each 10% of blood volume, PETCO2, arterial carbon dioxide partial pressure(PaCO2), mean arterial pressure and cardiac output were measured. After 40% blood loss, the percent decrease in PETCO2 decreased significantly. The percent decrease in PETCO2 correlated with the percent decrease in cardiac output(slope=0.33, r=0.7, P<0.001). The percent decrease in PETCO2 correlated with the percent decrease in cardiac output(slope=0.35, r=0.55, P<0.05). There is a linear correlation between the percent decrease in PETCO2 and cardiac outpit with the ratio approximately 1:3 during acute hemorrhage in the constant tidal volume ventilation. The cause of PETCO2 change induced by cardiac output might be change in PaCO2. This finding suggests that PETCO2 monitoring can easily detect a critical reduction in cardiac output when ventilationis constant.
[English]
Mannitol is used to reduce brain volume and intracranial pressure. These effects facilitate the surgical approach to deep-lying structures of cranial cavity. Intraoperatively, mannitol is administered in dose ranges of 0.25~1g/kg. The administration of mannitol may cause adverse effects. such as; rebound of intracranial pressure, transient increases in circulating blood volume, increased serum osmolality and decreased serum electrolytes. This study examined the influence of 20% mannitol on serum osmolality and electrolytes in 24 patients undergoing brain tumor, cerebral aneurysm and intracerebral hemmorrhage surgery. Measurement were made before the infusion of mannitol. 15 minutes following infusion. after dural closure and in the ICU. There was a significant increase in serum osmolalitv after infusion of mannitol. There was a significant decrease .in serum Na+ only 15 minutes following infusion. There was a significant decrease in serum K+ 15 minutes postinfusion and dural closure. In conclusion, it is important to measure osmolality and electrolytes before and after infusion and adjust fluid administration.
[English]
Incomplete antagonism of competitive neuromuscular blockade is a potentially lethal complication in postoperative period. Assessment of recovery from nondepolarizing neuromuscular block has been based on clinical criteria such as; head lift, hand grip strength, adequate tidal volume, vital capscity and inspiratory force which mostly require a cooperative patient. Other criteria, indepent of patient cooperation have been the interpretation of evoked muscle responses to single twich, tetanic and train-of-four stimulation. The present prospective investigation compare the incidence of residual neuromuscular blockade using train-of-four responses following administration and reversal of pancuronium and vecuronium in obstetric patients. The results were as follows: 1) The mean TOF ratio(T4/T1) in pancuronium group was 0.75±0.05. 2) The mean TOF ratio(T4/T1) in vecuronium group was 0.85±0.04. 3) 50% of patients(10/20) in the pancuronium group evidenced a ratio below 0.7, 20% of patients(4/20) in the vecuronium group was evidenced a TOF ratio below 0.7. In conclusion, the present study emphasizes the potential for residual neuromuscular blockade in patients who received pancuronium. In contrast, patients administered vecuronium appear to have a grater margin of safty postoperatively.
[English]
Arterial hypoxemia is a frequent occurrence in the immediate postoperaive period. For this reason many patients are given supplemental oxygen after operation. The present study was undertaken to compare the oxygenation by the various techniques (room air, reservoir tube, nasal cannula and simple mask) of administration in 40 patients in the recovery room. The results were as follows : 1) All patients were not found to be hypoxic at the time of admission in the recovery room. 2) There were significant increase of PaO2 and saO2 in reservoir tube, nasal cannula and simple mask group. 3) There were no significant changes in arterial pH, PaCO2 and base excess. In conclusion, resevoir tube is recommended effective and convenience device as means of oxygenation in the postopertive period.
[English]
Laryngoscopy and tracheal intubation after induction of anesthesia with thiopental are frequently associated with hypertension and tachycardia. The transient circulatory response are innocuous in healthy patients but detrimental to those with ischemic heart disease or increased ICP. The effect of sublingual and intranasal nifedipine was studied in 51 patients undergoing elective surgery. Patients were allocated randomly to receive sublingual or in intranasal nifedipine 10mg 5 minutes before induction. Anesthesia was induced thiopintal 5mg/kg and tracheal intubation was facliitated with succinylcholine 2mg/kg. The systolic, diastolic blood pressure, heart rate and rate-pulse product were recorded before the induction, 0, 2, 8, 13 minutes after intubation and skin incision. The results were as follows : 1) Significant attenuation of increase systolic BP in intranasal group compared to control group immediately after intubation. 2) Significant attenuation of increase in diastolic BP in intranasal group compared to control group. 3) Heart rate was significantly increased intranasal group and sublingual group compared to control group. 4) Slight obtundation of increase in rate-pulse product in sublingual and intranasal group, but not significant. In conclusion, intranasal nifedipine was effective method to attenuate the hypertensive response to laryngoscopy and tracheal intubation.
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, Guie Young Lee
