Computerize anesthesia record keeping in thoracic surgery--suitability of electronic anesthesia records in evaluating predictors for hypoxemia during one-lung ventilation.

Objective: The aim of this retrospective study was to assess the suitability of routine data gathered with a computerized anesthesia record keeping system in investigating predictors for intraoperative hypoxemia (SpO2 < 90%) during one-lung ventilation (OLV) in pulmonary surgery.

Methods: Over a four-year period data of 705 patients undergoing thoracic surgery (pneumonectomy: 78; lobectomy: 292; minor pulmonary resections: 335) were recorded online using an automated anesthesia record-keeping system. Twenty-six patient-related, surgery-related and anesthesia-related variables were studied for a possible association with the occurrence of intraoperative hypoxemia during OLV.

Small-dose nitric oxide improves oxygenation during one-lung ventilation: an experimental study.

Unlabelled: Inhaled nitric oxide (NO) at 20 or 40 ppm does not improve arterial oxygenation during one-lung ventilation (OLV). The authors hypothesized that NO at smaller concentrations might improve oxygenation. Twelve piglets weighing 26 to 32 kg were studied.

Combination of external chest wall oscillation with continuous positive airway pressure.

We studied the effects of continuous positive airway pressure (CPAP) on pulmonary gas exchange during external chest wall oscillation (ECWO), and the relationship with obesity, in nine patients with normal body weight (group 'N') and 10 obese patients (group 'O'). During ECWO with CPAP 5, PaCO2 decreased in group 'O' (6.0 (SD 0.

Controlled hypercapnia during one-lung ventilation in patients undergoing pulmonary resection.

Background: In a pilot study, the haemodynamic and gas exchange effects of acute hypercapoia during one-lung ventilation in thoracotomy patients were investigated. The effects of normocapnic one-lung ventilation (OLV-N) on haemodynamics and pulmonary gas exchange were compared with those of hypercapnic one-lung ventilation (OLV-H) in 14 patients undergoing pulmonary lobectomy.

Methods: Hypercapnia was induced by decreasing tidal volume until PaCO2 increased to 8-9 kPa.

Factors determining length of stay of surgical day-case patients.

Background And Objective: Factors which lead to prolonged stay in the day-care unit and unplanned admission after day-case surgery are poorly understood.

Methods: Data sets of 3152 day-case patients were collected with a computerized online record keeping system (NarkoData). Predictors of prolonged postoperative stay including unanticipated admission were identified using univariate analysis.

[Influences and predictors of unanticipated admission after ambulatory surgery].

Unlabelled: In order to plan the daily routine of a surgical day care unit optimally and effectively, it is indispensable to know the causes of unanticipated admission of outpatients. The purpose of this experiment was to evaluate the influences and predictors of unanticipated admission of patients in our day care unit for ambulatory surgery. The data sets of 3152 surgical outpatients were evaluated.

Effects of dopexamine and volume loading on hemodynamics and oxygenation parameters in patients undergoing pulmonary resection.

Background: Pulmonary resection may result in a reduction in arterial oxygen pressure as well as in cardiac output. Since cardiac index, oxygen delivery, and oxygen consumption are considered as important determinants of patients' outcome, we evaluated the effects of dopexamine and volume loading on cardiopulmonary variables in patients undergoing pulmonary resection.

Methods: Forty adult patients undergoing pulmonary resection for lung or bronchial tumors were included in an open placebo-controlled study.

[Recovery of balanced anesthesia with various inhalation anesthetics in comparison to intravenous anesthetics: a retrospective analysis of 20,060 patients].

Background: The aim of this investigation was to compare routine balanced anaesthesia with different inhalation agents to intravenous anaesthesia (IVA) using an Anaesthesia-Information-Management-System (AIMS) with regard to time of recovery from anaesthesia, the time of discharge from the postanaesthesia care unit (PACU) and postoperative nausea as well as postoperative therapy with analgesics.

Methods: In 1997 and 1998 all relevant data of each anaesthesia procedure have been recorded using the online documentation Software NarkoData. These data sets have been stored into a relational database during each anaesthesia procedure.

Effects of low-dose dopexamine on splanchnic oxygenation during major abdominal surgery.

Objective: To study the influence of low-dose dopexamine on splanchnic oxygenation during major abdominal surgery.

Design: Prospective, randomized, placebo-controlled study.

Setting: University hospital.

[The effects of dopexamine. Transpulmonary shunt volume in thoracic surgical procedures with one-lung respiration].

Objective: To study the influence of dopexamine on pulmonary shunt and hypoxic pulmonary vasoconstriction during major thoracic surgery with one-lung ventilation (OLV).

Design: Prospective, randomised, placebo-controlled study.

Setting: University hospital.

Value of body plethysmography in preoperative assessment of thoracotomy candidates.

The usefulness of body plethysmography in the assessment of thoracotomy candidates is not well documented. Reported thresholds for operability are generally expressed in absolute values, which do not take into account a patient's size, age or gender. Spirometric and plethysmographic data of 103 patients undergoing thoracotomy were examined for their ability to predict death due to cardiopulmonary insufficiency, pneumonia, and atelectasis during the first 30 postoperative days.

[Effects of lumbar peridural anesthesia on tissue pO2 of the large intestine in man].

Aim: The aim of this study was to investigate the effect of 15 ml bupivacaine 0.25%, given via an epidural catheter, on the tissue-PO2 of the colon wall in humans.

Methods: Nine patients were studied during elective colorectal surgery.

[Accidental anesthetic overdose caused by anesthesia respirators Servo 900 C and D].

When working with the anaesthetics vaporizers/respirators of the type Siemens Servo 900 C/D we found differences between the values adjusted at the instrument and those measured by the anaesthetic gas monitor (Sirecust 734 G). Control measurements yielded differences of inspiratory concentrations of halothane and isoflurane that were in excess by up to 80%. We found that the reason for this was the absence of reducing valves at the respirator that would reduce the static pressure of central gas supply from 5.

[Structure and organization of ambulatory and day treatment in a university clinic].

Massive increases in costs of health care on one hand and the development of "minimal invasive" surgical techniques on the other hand have enforced an ambulatory or "day-care" treatment policy. Yet, the involvement of hospitals in ambulatory treatment has been limited in Germany, but in the near future this situation will change. In a small number of major hospitals, day surgery programs are going to be established even for infants or for patients at risk for prolonged postoperative monitoring or hospitalization.

[Volume substitution in acute normovolemic hemodilution. 5% human albumin vs. 6% hydroxyethyl starch].

In order to ascertain the hemodynamic and biochemic effect of different colloid solutions, 60 patients scheduled for hip arthroplasty were randomly divided into two groups. Prior to surgery, acute normovolemic hemodilution was performed by withdrawal of 15 ml blood/kg bodyweight and simultaneous compensation using either 5% human albumine (HA) or 6% hydroxyethylstarch (200/0.5) (HAES), each group consisting of 30 patients.

Effects of hypothermia on somatosensory evoked responses in man.

Somatosensory evoked responses after median nerve stimulation were recorded in 21 patients during hypothermic cardiopulmonary bypass. During hypothermia a significant linear correlation (P less than 0.001) was found between evoked potential latency and temperature.