Thermodilution cardiac output measurements during conventional and high-frequency ventilation.

The thermodilution method for cardiac output determinations correlates well with Fick and dye dilution methods. Experimental work with thermodilution techniques has shown that individual measurements of right heart cardiac output during conventional ventilation vary throughout the respiratory cycle. The aims of this study were to compare thermodilution cardiac output determinations made at a fixed point (zero end-expiratory pressure [ZEEP]) with those made randomly throughout the respiratory cycle during conventional controlled positive pressure ventilation (CPPV) and high-frequency jet ventilation (HFJV) with up to 10 cm H2O positive endexpiratory pressure (PEEP).

Comparison of conventional intermittent positive pressure ventilation with high frequency jet ventilation. Studies following aortocoronary bypass graft surgery.

This study was designed to compare the cardiorespiratory effects of high frequency jet ventilation at 150 breaths/minute with and without added positive and expiratory pressure, with conventional intermittent positive pressure ventilation in 20 patients following aortocoronary bypass graft surgery. On comparison with intermittent positive pressure ventilation, there was a decrease in peak airway pressure during high frequency jet ventilation when positive and expiratory pressure of 0 or 0.5 kPa was applied, but not with 1 kPa, and an increase in mean airway pressure with positive end expiratory pressures of 0.

Epidural diamorphine and the metabolic response to upper abdominal surgery.

The effect of the administration of diamorphine 10 mg epidurally on the metabolic response to cholecystectomy was investigated and compared with a control group of patients given intravenous papaveretum. There were no significant differences in blood glucose, lactate and pyruvate, and plasma nonesterified fatty acid values between the epidural diamorphine group and the control group. Plasma cortisol concentrations were significantly lower in the epidural diamorphine group postoperatively and this was associated with a marked improvement in pain relief.

Continuous intravenous infusion of disoprofol (ICI 35868, Diprivan). Comparison with Althesin to cover surgery under local analgesia.

Disoprofol has been used to induce and, by continuous infusion, to maintain a light level of general anaesthesia in 100 patients undergoing surgery with the aid of a regional block. Its effects have been compared with 100 patients anaesthetised in a similar manner with Althesin. Disoprofol proved to be a very satisfactory agent for use by this method and apart from an appreciable incidence of pain on injection the number of complications was small and comparable to those found with Althesin, which caused more involuntary movements.

The prolonged Q-T syndrome. A review with anaesthetic implications and a report of two cases.

Inherited prolongation of the Q-T interval is associated with syncopal attacks due to ventricular arrhythmias, which, if untreated, are often fatal at an early age. The condition is reviewed and the anaesthetic management of two patients with the syndrome presented. The importance of recognition of the syndrome and its treatment with beta-blockers is stressed.