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A Comparison of Arterial Oxygenation between 60% O₂ CPAP and 100% O₂ CPAP during One-Lung Ventilation: A Prospective Randomized Controlled Study

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Open Journal of Anesthesiology 2023年第1期13卷 1-14页

作者： Yuko Yamada kumiko tanabe Kiyoshi Nagase Hiroki Iida Department of Anesthesiology and Pain Medicine Gifu University Graduate School of Medicine Gifu Japan Anesthesiology and Pain Relief Center Central Japan International Medical Center Minokamo Gifu Japan

Background: One-lung ventilation (OLV) is generally adopted for thoracic surgery. The systemic application of a high fraction of inspiratory oxygen (F1O2) and continuous positive airway pressure (CPAP) to the non-ventilated lung is useful for preventing arterial oxygen desaturation. The adverse effects of elevated F1O2 include oxidative lung injury, resorption atelectasis and coronary and peripheral vasoconstriction. It is preferable to avoid hyperoxemia in patients with complications such as chronic obstructive pulmonary disease, idiopathic pneumonia, and bleomycin-treated lungs. We aimed to determine whether the application of 60% O2 CPAP to the non-ventilated lung is sufficient to provide adequate oxygenation with 60% O2 to the ventilated lung. Methods: A total of 70 patients scheduled to receive elective thoracic surgery requiring OLV were recruited. Left double-lumen tubes were applicable in all surgeries. Patients were randomly allocated to one of two groups, to receive either 60% O2 CPAP (60% CPAP group, n = 35), or 100% O2 CPAP (100% CPAP group, n = 35) at a setting of 2 - 3 cmH2O, applied to the non-ventilated lung. Arterial blood gas analyses were obtained at the following stages: RA, spontaneous breathing under room air (RA);TLV, during total lung ventilation (TLV) prior to the initiation of OLV;T5, 5 min after the initiation of OLV;T15, 15 min after the initiation of OLV;T30, 30 min after the initiation of OLV. Results: The PaO2 value in 60% CPAP group vs. 100% CPAP group at each measurement were as follows: RA (mean [standard deviation: SD], 89.7 [8.2] mmHg vs. 85.8 [11.9] mmHg);TLV (277.9 [52.9] mmHg vs. 269.2 [44.0] mmHg);T5 (191.4 [67.9] mmHg vs. 192.3 [66.0] mmHg);T15 (143.2 [67.3] mmHg vs. 154.7 [60.8] mmHg) and T30 (95.6 [32.0] mmHg vs. 112.5 [36.5] mmHg), respectively. Among the five measurement points, T30 was the only time point at whic

关键词： CPAP Double-Lumen Tube Hyperoxemia Hypoxemia One-Lung Ventilation

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The Cardiac Function in the Beach Chair Position under General Anesthesia

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Open Journal of Anesthesiology 2018年第1期8卷 27-34页

作者： kumiko tanabe Yuko Yamada Kiyoshi Nagase Nobuo Terabayashi Hiroki Iida Department of Anesthesiology and Pain Medicine Gifu University Graduate School of Medicine Gifu Japan Department of Orthopaedic Surgery Gifu University Graduate School of Medicine Gifu Japan

Background: Shoulder surgery is performed in the beach chair position (BCP). The systemic arterial blood pressure (BP) must be increased to prevent cerebral hypoperfusion. However, it is not clear how the cardiac function is affected when BP increase to maintain cerebral perfusion pressure in anesthetized patients. Methods: An analysis was performed using the data from 13 patients. We prepared a parallel circuit using a FloTrac Sensor transducer and an arterial BP transducer. Following the transfer of the patient to the BCP under general anesthesia, the FloTrac Sensor transducer was placed at the level of the fourth intercostal space, the arterial BP transducer was placed at the external auditory meatus level. We selected two points before surgery (120 s apart), during which the mean arterial BP (mABP) at the level of the brain was stable and at which the values in the supine position and the BCP were within 5 mmHg. Results: While the patients were in the supine position, the mean mABP at the mid-axillary level was 65.7 mmHg. In the BCP, the mean mABP was 66.5 mmHg at the external auditory meatus and 80.7 mmHg at the fourth intercostal space. The cardiac index changed from 2.2 (supine position) to 2.5 l/min/m2 (BCP). The stroke volume index was significantly increased from 35.8 to 42.3 ml/m2 (P = 0.003). The heart rate changed from 63.0 to 58.6 beats/min. The stroke volume variation was significantly decreased from 12.4% to 8.8% (P = 0.024). Conclusion: In order to ensure patient safety, close attention should be paid to the systemic cardiovascular changes that occur when the BP is increased.

关键词： Beach Chair Position Cardiac Function Cerebral Perfusion

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The Pattern of Contrast Dye through the Thoracic Paravertebral Catheter Does Not Predict Analgesic Efficacy after Breast Cancer Surgery: A Prospective Cohort Study

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Open Journal of Anesthesiology 2018年第12期8卷 285-294页

作者： Yuko Yamada kumiko tanabe Noritaka Yoshimura Shinobu Yamaguchi Kiyoshi Nagase Hiroki Iida Department of Anesthesiology and Pain Medicine Gifu University Graduate School of Medicine Gifu Japan

Purpose: We examined whether or not the spreading pattern of contrast dye through the catheter into the thoracic paravertebral space (TPVS) was associated with acute post-operative pain relief after breast cancer surgery. Methods: Sixty patients were recruited. After surgery, patients received thoracic paravertebral block (TPVB). The catheter was inserted within the TPVS, and radiographic contrast dye was injected through the catheter. Based on the main spreading patterns of the dye, the patients were divided into a cloud-like (spreading to the posterior compartment of the TPVS) or a longitudinal spread group (spreading to the anterior compartment of the TPVS). The primary endpoint of the study was pain intensity by numeric rating scale (NRS) and additional analgesic requirements within 12 h after surgery. Results: In 22 patients, the spread of contrast dye was not noted in the PVS. Of the 38 eligible patients, 9 patients were assigned to the cloud-like spread group, 28 patients to the longitudinal spread group and 1 patient was excluded. There were no significant differences in the NRS between the two groups both at rest and on moving. No significant differences were found in the frequency of requiring additional analgesics. Conclusions: There is no marked difference in the analgesic efficacy after breast cancer surgery based on the spread of the contrast dye to the posterior or anterior compartment of the TPVS. We should not insert the needle deeply within the TPVS, as the risk of the migration of catheters into the pleural space can be quite high.

关键词： Breast Cancer Postoperative Pain Thoracic Paravertebral Block

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In vitro and in vivo development of interspecies Asian elephant embryos reconstructed with pig enucleated oocytes

In vitro and in vivo development of interspecies Asian eleph...

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中国畜牧兽医学会动物繁殖学分会第二十次学术研讨会

作者： Tien Dat Nguyen Honghui Li Yiquan Zhuang Bowei Chen Keiji Kinoshita Muhammad Ameen Jamal Kaixiang Xu Jianxiong Guo Deling Jiao kumiko tanabe Yunfang Wei Zhuo Li Wenming Cheng Yubo Qing Hong-Ye Zhao Hong-Jiang Wei

Purpose De-extinction to bring back the wooly mammoths would be a tremendous accomplishment for humanity and has always been the dream of *** revive them,three main strategies （ICSI,SCNT,gene-editing） using elephant oocytes are under *** the elephant oocytes seem to be an indispensable recipient for reviving the wooly ***,the elephant （Elephas maximus.L） is also categorized as an endangered *** somatic cell nuclear transfer（iSCNT） has an immense potential to rescue endangered animals and extinct species like mammoths.

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Argon plasma coagulation for superficial esophageal squamous-cell carcinoma in high-risk patients

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World Journal of Gastroenterology 2012年第38期18卷 5412-5417页

作者： kumiko Tahara Satoshi tanabe Kenji Ishido Katsuhiko Higuchi Tohru Sasaki Chikatoshi Katada Mizutomo Azuma Kento Nakatani Akira Naruke Myungchul Kim Wasaburo Koizumi Department of Gastroenterology Kitasato University East Hospital Kanagawa 252-0380 Japan

AIM: To evaluate the usefulness and safety of argon plasma coagulation (APC) for superficial esophageal squamous-cell carcinoma (SESC) in high-risk patients. METHODS: We studied 17 patients (15 men and 2 women, 21 lesions) with SESC in whom endoscopic mucosal resection (EMR), endoscopic submucosal dissection (ESD), and open surgery were contraindicated from March 1999 through February 2009. None of the patients could tolerate prolonged EMR/ESD or open surgery because of severe concomitant disease (e.g., liver cirrhosis, cerebral infarction, or ischemic heart disease) or scar formation after EMR/ESD and chemoradiotherapy. After conventional endoscopy, an iodine stain was sprayed on the esophageal mucosa to determine the lesion margins. The lesion was then ablated by APC. We retrospectively studied the treatment time, number of APC sessions per site, complications, presence or absence of recurrence, and time to ***: The median duration of follow-up was 36 mo (range: 6-120 mo). All of the tumors were macroscopically classified as superficial and slightly depressed type (0-Ⅱc). The preoperative depth of invasion was clinical T1a (mucosal cancer) for 19 lesions and clinical T1b (submucosal cancer) for 2. The median treatment time was 15 min (range: 10-36 min). The median number of treatment sessions per site was 2 (range: 1-4). The median hospital stay was 14 d (range: 5-68 d). Among the 17 patients (21 lesions), 2 (9.5%) had recurrence and underwent additional APC with no subsequent evidence of recurrence. There were no treatment-related complications, such as bleeding or perforation. CONCLUSION: APC is considered to be safe and effective for the management of SESC that cannot be resected endoscopically because of underlying disease, as well as for the control of recurrence after EMR and local recurrence after chemoradiotherapy.

关键词： Argon plasma coagulation Superficial esophageal cancer Squamous-cell carcinoma High-risk patient Endoscopic therapy

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