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Accuracy of two-compartment modelling of gas exchange with ventilation-perfusion mismatch in inhalational anesthesia.
Anesthesiology
January 2025
Department of Critical Care, Melbourne Medicine School, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Victoria, Australia.
Background: Multi-compartment computer models of heterogeneity in alveolar ventilation-perfusion ratios (VA/Q scatter) across the lung explain the significant alveolar-arterial (A-a) partial pressure gradients and associated alveolar dead-space fractions (VDA/VA) seen in anesthetized patients for both carbon dioxide and for anesthetic gases of different blood solubilities. However, the accuracy of a simpler two-compartment model of VA/Q scatter to do this has not been tested or compared to calculations from the traditional Riley model with "ideal", unventilated (shunt) and unperfused (deadspace) compartments.
Methods: Measurements of gas partial pressures in inspired and expired gas and arterial and mixed venous blood from 29 patients undergoing inhalational general anesthesia for cardiac surgery was used to compare the accuracy of two simple models of VA/Q scatter and lung gas exchange in predicting measured alveolar and arterial partial pressure differences, and associated alveolar dead-space calculations for the modern anesthetic gases isoflurane, sevoflurane and desflurane.
Synergy between two different paraspinal fascial plane blocks in robotic thoracic surgery: unity is strength.
Minerva Anestesiol
January 2025
Department of Thoracic Surgery. G. Mazzini Hospital, University of L'Aquila, Teramo, Italy.
Ulinastatin treatment mitigates glycocalyx degradation and associated with lower postoperative delirium risk in patients undergoing cardiac surgery: a multicentre observational study.
Crit Care
January 2025
Department of Anesthesiology, Hubei Key Laboratory of Geriatric Anesthesia and Perioperative Brain Health, Wuhan Clinical Research Center for Geriatric Anesthesia, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095# Jiefang Ave, Wuhan, 430030, China.
Background: Ulinastatin (UTI), recognized for its anti-inflammatory properties, holds promise for patients undergoing cardiac surgery. This study aimed to investigate the relationship between intraoperative UTI administration and the incidence of delirium following cardiac surgery.
Methods: A retrospective analysis was performed on a retrospective cohort of 6,522 adult cardiac surgery patients to evaluate the relationship between UTI treatment and the incident of postoperative delirium (POD) in patients ongoing cardiac surgery.
Vasoplegia in Heart, Lung, or Liver Transplantation: A Narrative Review.
J Cardiothorac Vasc Anesth
January 2025
Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, Boston, MA.
Vasoplegia is a pathophysiologic state of hypotension in the setting of normal or high cardiac output and low systemic vascular resistance despite euvolemia and high-dose vasoconstrictors. Vasoplegia in heart, lung, or liver transplantation is of particular interest because it is common (approximately 29%, 28%, and 11%, respectively), is associated with adverse outcomes, and because the agents used to treat vasoplegia can affect immunosuppressive and other drug metabolism. This narrative review discusses the pathophysiology, risk factors, and treatment of vasoplegia in patients undergoing heart, lung, and liver transplantation.
View Article and Find Full Text PDFEPIDURAL ADMINISTRATION OF TRAMADOL DOES NOT PROVIDE SUFFICIENT INTRAOPERATIVE ANALGESIA FOR ELECTIVE OVARIOHYSTERECTOMY IN HEALTHY CATS.
Top Companion Anim Med
January 2025
Department of Small Animal Clinic, Centre of Rural Sciences, Federal University of Santa Maria (UFSM), Rio Grande do Sul State, Brazil.
Few studies today address trans-operative analgesia provided by tramadol without local anesthetics for intra-abdominal procedures. The objective of this study was to assess the efficacy of trans-operative analgesia provided by epidurally administered tramadol in cats undergoing elective ovariohysterectomy. For this purpose, 16 healthy queens were randomly assigned to participate in one of two groups: GC, control group, 0.
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