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Prolonged hypervolemic hemodilution decreases functional capillary density of ileal mucosa in pigs revealed by sidestream dark-field imaging

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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2011年第10期12卷 867-874页

作者： Zdenek TUREK vladimir cerny Renata PARIZKOVA Jindrich SAMEK Martin OBERREITER Department of Anesthesiology and Intensive Care University Hospital Hradec KraloveCharles University in PragueHradec Kralove 500 05Czech Republic Department of Surgery University Hospital Hradec KraloveCharles University in PragueHradec Kralove 500 05Czech Republic

Objective： Hemodilution changes the physical properties of blood by reducing its hematocrit and blood viscosity. We tested whether prolonged hypervolemic hemodilution （HHD） impairs functional capillary density （FCD） of ileal mucosa in healthy mechanically-ventilated pigs and if there is any correlation between changes in FCD of ileal and sublingual mucosas during HHD. Methods： Sixteen domestic female pigs were anesthetized, mechanically-ventilated, and randomly assigned to the HHD （20 ml/（kg.h） Hartmann＇s solution for 3 h） or fluid restrictive （5 ml/（kg-h） Hartmann＇s solution for 3 h） group. Microcirculations of sublingual and ileal mucosas via ileostomy were visualized using sidestream dark-field （SDF） imaging at baseline conditions （t=0 h） and at selected time intervals of fluid therapy （t=-l, 2, and 3 h）. Results： A significant decrease of ileal FCD （285 （278-292） cm/cm^2） in the HHD group was observed after the third hour of HHD when compared to the baseline （360 （350-370） cm/cm2）（P〈0.01）. This trend was not observed in the restrictive group, where the ileal mucosa FCD was significantly higher after the third hour of fluid therapy as compared to the HHD group （P〈0.01）. No correlation between microhemodynamic parameters obtained from sublingual and ileal mucosas was found throughout the study. Conclusions： Prolonged HHD established by crystalloid solution significantly decreased ileal villus FCD when compared to restrictive fluid regimen. An inappropriate degree of HHD can be harmful during uncomplicated abdominal surgery.

关键词： Hypervolemic hemodilution Intestinal microcirculation Sidestream dark-field imaging

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Case of morphine-induced ventricular fi brillation

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World Journal of Emergency Medicine 2017年第4期8卷 310-312页

作者： Roman Skulec Jitka Callerova Jiri Knor Petr Ostadal Petr Kmonicek vladimir cerny Department of Anesthesiology Perioperative Medicine and Intensive Care J.E. Purkinje University Masaryk Hospital inUsti nad Labem Usti nad Labem Czech Republic Emergency Medical Service of the Central Bohemian Region Kladno Czech Republic Department of Anesthesiology and Intensive Care Charles University in Prague Faculty of Medicine in Hradec KraloveUniversity Hospital Hradec Kralove Hradec Kralove Czech Republic 3rd Medical Faculty Charles University in Prague Prague Czech Republic Cardiovascular Center Na Homolce Hospital Prague Czech Republic Department of Anesthesia Pain Management and Perioperative Medicine Dalhousie University Halifax Nova Scotia Canada Department of Research and Development and Department of Anesthesiology and Intensive Care Charles University inPrague Faculty of Medicine in Hradec Kralove University Hospital Hradec Kralove Hradec Kralove Czech Republic

Morphine is considered as a traditional and safemedication to relieve pain and dyspnea in the setting of acutecoronary syndrome and cardiogenic pulmonary edema.[1,2]It is also attributed to dispose an antiarrhythmic effect.[3] Wereport a case of morphine-induced ventricular fi brillation inthe prehospital emergency treatment. The patient presentedacute myocardial infarction with ST segment elevationscomplicated with uncontrolled hypertension and cardiogenicpulmonary edema.

关键词： morphine-induced ventricular fi brillation

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Expert consensus on difficult airway assessment

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Hepatobiliary Surgery and Nutrition 2023年第4期12卷 545-566页

作者： Ming Xia Wuhua Ma Mingzhang Zuo Xiaoming Deng Fushan Xue Denise Battaglini Vivek Aggarwal Giustino Varrassi vladimir cerny Ida Di Giacinto Rita Cataldo Daqing Ma Toru Yamamoto Martina Rekatsina Alessandro De Cassai Andrea Carsetti Marvin G.Chang Edwin Seet Daniel P.Davis Michael G.Irwin Yuguang Huang Hong Jiang Department of Anesthesiology Shanghai Ninth People’s HospitalShanghai Jiao Tong University School of MedicineShanghaiChina Department of Anesthesiology The First Affiliated Hospital of Guangzhou University of Chinese MedicineGuangzhouChina Department of Anaesthesiology Beijing HospitalNational Center of GerontologyInstitute of Geriatric MedicineChinese Academy of Medical ScienceBeijingChina Department of Anesthesiology Plastic Surgery HospitalCAMS and PUMCBeijingChina Department of Anesthesiology Beijing Friendship HospitalCapital Medical UniversityBeijingChina Anesthesia and Intensive Care San Martino Policlinico HospitalIRCCS for Oncology and NeuroscienceGenoaItaly Department of Conservative Dentistry&Endodontics Jamia Millia IslamiaNew DelhiIndia Paolo Procacci Foundation RomaItaly Department of Anaesthesiology and Intensive Care Medicine University Hospital Hradec KraloveHradec KraloveCzech Republic Unit of Anesthesia and Intensive Care Mazzoni HospitalAscoli PicenoItaly Unit of Anaesthesia Intensive Care and Pain ManagementDepartment of MedicineUniversitàCampus Bio-Medico of RomeRomaItaly Division of Anaesthetics Pain Medicine&Intensive CareDepartment of Surgery&CancerFaculty of MedicineImperial College Londonand Chelsea and Westminster HospitalLondonUK Division of Dental Anesthesiology Graduate School of Medicine and Dental SciencesNiigata UniversityNiigataJapan Department of Anaesthesiology National and Kapodistrian University of AthensAthensGreece Institute of Anesthesia and Intensive Care Unit University Hospital of PaduaPaduaItaly Department of Biomedical Sciences and Public Health UniversitàPolitecnica delle MarcheAnconaItaly Anesthesia and Intensive Care Unit Azienda Ospedaliero Universitaria delle MarcheAnconaItaly Department of Anesthesia Critical Careand Pain MedicineMassachusetts General HospitalBostonMAUSA Lee Kong Chian School of Medicine Nanyang Technological UniversitySingaporeSingapore Department of Anaesthesia Yong Loo Lin School of Medic

Background:Identifying a potentially difficult airway is crucial both in anaesthesia in the operating room(OR)and non-operation room *** are no guidelines or expert consensus focused on the assessment of the difficult airway before,so this expert consensus is developed to provide guidance for airway assessment,making this process more standardized and accurate to reduce airway-related complications and improve ***:Seven members from the Airway Management Group of the Chinese Society of Anaesthesiology(CSA)met to discuss the first draft and then this was sent to 15 international experts for review,comment,and *** Grading of Recommendations,Assessment,Development and Evaluation(GRADE)is used to determine the level of evidence and grade the strength of *** recommendations were revised through a three-round Delphi survey from ***:This expert consensus provides a comprehensive approach to airway assessment based on the medical history,physical examination,comprehensive scores,imaging,and new developments including transnasal endoscopy,virtual laryngoscopy,and 3D *** addition,this consensus also reviews some new technologies currently under development such as prediction from facial images and voice information with the aim of proposing new research directions for the assessment of difficult ***:This consensus applies to anesthesiologists,critical care,and emergency physicians refining the preoperative airway assessment and preparing an appropriate intubation strategy for patients with a potentially difficult airway.

关键词： Expert consensus difficult airway airway management

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