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An In Vivo Evaluation of the Mycobacterial Filtration Efficacy of Three Breathing Filters Used in Anesthesia

麻醉与监护论坛 2011年第3期18卷 215-221页

作者： Daniel P. Vezina Claude A. Trepanier Martin R.Lessard Marie Gourdeau Claude Tremblay Robert Guidoin Resident Department of Anesthesiology Laval University. Current position：Assistant Professor of Anesthesiology andMedicine University of Utah Salt Lake City Utah associate Clinical professor associate Clinical professor and chairman Department of Anesthesiology Assistant Clinical professor Associate Clinical Professor Department of Medicine （Microbiology） Laval University professor Department of Surgery Laval University Quebec Canada

Background:The use of breathing filters (BFs) has been recommended to protect the anesthesia apparatus in proven or suspected cases of tuberculosis. Some investigators have also suggested the use of BF to alleviate the need to change anesthesia breathing circuits after each case. This study evaluated the filtration efficacy of three different BFs to prevent mycobacterial contamination of breathing circuits in a model that uses a test animal. Methods:Ten Pall BB25A (pleated hydrophobic) (Pall Canada Ltd., Mississauga, Ontario, Canada), six DAR Barrierbac S (felted electrostatic; Mallinckrodt DAR, Mirandola, Italy), and six Baxter Airlife (felted electrostatic; Baxter Canada, Mississauga, Ontario, Canada) BFs were studied. For each BF tested, 20 ml of a high concentration suspension of Mycobacterium chelonae (range, 2.0×10^7 to 9.0×10^7 colony-forming units/ml) was nebulized during 2h at the proximal end of the endotracheal tube of anesthetized pigs. At the end of the nebulization period, the BFs were sampled for culture. The titer reduction value (number of microorganisms challenging the BF divided by the number of microorganisms recovered downstream of the BF) and the removal efficiency (difference between the number of microorganisms challenging the BF and the number of microorganisms recovered downstream of the BF, divided by the number of microorganisms challenging the BF) were calculated. Results:The median titer reduction values were 5.6×10^5, 6.0×10^5, and 8.0×10^8 (P < 0.0005), and the median removal efficiencies were greater than 99.999%, greater than 99.999%, and 100% (P= not significant) for the DAR Barrierbac S, the Baxter Airlife, and the Pall BB25A, respectively. Conclusions:Among the three BFs studied, only the Pall BB25A completely prevented the passage of M. chelonae, thus protecting the anesthesia breathing circuit from mycobacterial contamination.

关键词：英文摘要内容介绍编辑工作期刊

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Safety and Efficacy of Pediatric General Anesthesia by Laryngeal Mask Airway Without Intravenous Access

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International Journal of Clinical Medicine 2011年第3期2卷 328-331页

作者： Benjamin A. Lin BSc Zakaria S Messieha William E Hoffman associate professor Anesthesiology University of Illinois Chicago Illinois

The safety and efficacy of the laryngeal mask airway (LMA) has been reported by numerous large-scale studies. However, they do not address the issue of whether an intravenous (IV) is required for pediatric general anesthesia (GA) where access is challenging due to anatomical considerations and a lack of cooperation. The aims of this study are to determine whether pediatric GA by LMA without IV access affected placement rates, procedure times and rates of anesthetic complications. Children who met these criteria at the UIC Surgicenter in the two year period prior to August 30, 2005 were selected. A retrospective chart review was conducted to determine patient demographics, ASA class, procedure, placement success, IV placed if any, time to incision, and any anesthetic complications. 241 patients without IV access and 41 patients with IV access were included. No significant differences were found between the groups in the rates of LMA placement or anesthetic complications. Significant differences were found in times to incision overall and for ophthalmology exams under anesthesia and lacrimal duct probings. Pediatric GA by LMA without IV access demonstrated a similarly high placement rate, shorter procedure times and a low rate of complications in comparison with the control group.

关键词： Pediatric Anesthesia Anesthesia Efficacy LMA Safety General Anesthesia Without Intravenous Cannulation

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七氟醚抑制脑干吸气前运动神经元的作用机制

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国外医学（麻醉学与复苏分册） 2005年第4期26卷 249-252页

作者： Astrid G.Stucke Edward J.Zuperku Viseslav Tonkovic-Capin Mirko Krolo Francis A.Hopp John P.Kampine Eckehard A.E.Stuth Zhongcong Xie 许鹏程曾因明 Research Fellow in anesthesiology associate professor of anesthesiology Research professor of anesthesiology associate professor of anesthesiology Biomedical Engineer associate professor of anesthesiology professor and chairman of anesthesiology associate professor of anesthesiology 哈佛大学麻省总医院江苏省麻醉学重点实验室

研究背景:位于延髓尾部腹侧髓质的神经元是与吸气相关的前运动神经元,它们是支配呼吸肌如膈肌、肋间外肌、肋间内肌等运动神经元的上一级神经元.这些神经元的兴奋状态由NMDA受体,AM-PA受体调控,也受抑制性AGBAA能神经调节.作者在去大脑... 详细信息

研究背景:位于延髓尾部腹侧髓质的神经元是与吸气相关的前运动神经元,它们是支配呼吸肌如膈肌、肋间外肌、肋间内肌等运动神经元的上一级神经元.这些神经元的兴奋状态由NMDA受体,AM-PA受体调控,也受抑制性AGBAA能神经调节.作者在去大脑狗的模型上探讨七氟醚对这些突触机制的影响。

关键词：前运动神经元七氟醚脑干 NMDA受体兴奋状态 PA受体神经调节突触机制膈肌

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Lighted Stylet （Trachlight） Enhances the Success of LMA-Classic^TM Placement

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麻醉与监护论坛 2011年第1期18卷 30-34页

作者： Chun- Yong Yang Fu-Hong Wan Lan Zhan Jin Liu David T. Wong Yun-Xia Zuo Resident Department of Anesthesiology Sichuan University ChengduSichuan 610041 P.R. China professor Department of Anesthesiology Sichuan University ChengduSichuan 610041 P.R. China associate professor Department of Anesthesiology University of TorontoOntario Canada

LMA-ClassicTM placement is difficult for some patients in our clinical practice. In this study, we have tested the feasibility of using lighted stylet to guide LMA-ClassicTM placement. We then further assessed cuff location with bronchofibroscopy and compared to those controls with LMA-ClassicTM being placed in classic approach in a randomised study of 100 patients. The successful insertion rate of the first attempt in the lighted stylet group was higher than that the control group. The effective airway establishing time was shorter in the lighted stylet group and the average cuff pressure required without leaking was significantly lower. The fibreoptic score of the LMA-ClassicTM cuff location assessment was significantly better in the lighted stylet group. The present study demonstrates that LS guided LMA-ClassicTM placement was feasible, associated with less placement time, a lower leak introcuff pressure and a higher FOB score, compared to conventional technique ofLMA-ClassicTM placement.

关键词：光导管引导罩支气管镜治疗方法临床分析

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What Is the Future of Swan-Ganz Catheter？

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麻醉与监护论坛 2009年第3期16卷 136-137页

作者： Hong Liu associate professor Department of Anesthesiology and Pain MedicineUniversity of California Davis Health System Sacramento9 CA USA

The pulmonary arterial catheter (PAC), also known as the Swan-Ganz catheter, was introduced in 1970 for clinical use. It can be placed in the operating room or intensive care unit (ICU) within a few minutes even in critically ill patients. Although placement of these catheters is not difficult, some training and experience are required to avoid complications and for proper interpretation of the hemodynamic data that can be obtained by PAC. Because of the many advantages of this catheter, they have been used without a proper indication and frequently overused in operating rooms and ICUs, resulting in many complications, including mortality.

关键词：肺动脉导管并发症血液动力学临床研究

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异氟醚预处理通过激活蛋白激酶C-δ诱发心肌纤维膜ATP敏感性钾通道持久敏感化

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国外医学（麻醉学与复苏分册） 2005年第5期26卷 312-317页

作者： Jasna Marinovic Zeljko J.Bosnjak Anna Stadnicka 李敬远 Research Fellow professor of anesthesiology and Physiology associate professor of anesthesiology 中国医科大学

背景:吸入麻醉药预处理的心肌保护作用机制涉及到心肌纤维膜ATP敏感性钾通道(sarcKATP)的激活,本实验通过研究短暂麻醉药预处理是否能产生持久sarcKATP敏感化,及其是否是通过蛋白激酶C(PKC)介导,进而研究麻醉药预处理的记忆时相.

关键词： ATP敏感性钾通道蛋白激酶C(PKC) 异氟醚预处理肌纤维膜激活吸入麻醉药诱发保护作用机制

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Subcutaneous Dissociative Conscious Sedation (sDCS) a New Approach to Compromised Airway in Mediastinal Masses

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Open Journal of anesthesiology 2012年第4期2卷 166-169页

作者： Mihan J. Javid Mohammad B. Rahim Shahab Rafiian associate professor of anesthesiology Department of Anesthesiology and Critical Care Imam Khomeinee Medical Center Tehran University of Medical Sciences Iran Department of Thoracic Surgery Imam Khomeinee Medical Center Tehran University of Medical Sciences Iran

Purpose: Anesthesia and airway management for mediastinal masses are challenging and are accompanied by mortality and morbidity. Avoiding the loss of airway muscular tone in mediastinal masses has been confirmed necessary to avoid airway collapse. Sufficient spontaneous ventilation is of paramount importance in order to reduce the rate of mortality and morbidity. Various anesthetics and anesthesia techniques have been used for maintaining spontaneous ventilation and patent airway. In this report, a successful double lumen endobronchial intubation using “subcutaneous dissociative conscious sedation” as a novel method in the management of compromised airway (a case of a mediastinal mass) is presented. Clinical features: A 42 year- old, 62 Kg man was presented for an open biopsy of a middle mediastinal mass. The patient had a history of chest pain, dyspnea, cough, fever and sweats for 2 months. Regarding to the life threatening nature of mediastinal masses resulting from unpredictable events of airway obstruction and the reported cases of deaths after induction of anesthesia in patients with mediastinal masses and regarding to the importance of not losing muscular tone and keeping airway tone intact in patients with mediastinal masses” subcutaneous Dissociative Conscious Sedation (a novel method of anesthesia)”was selected in order to guarantee the safety of the patient and keep the airway secure. Conclusion: Owing to the characteristics of the “subcutaneous dissociative conscious sedation” this method is suggested as an appropriate substitute to general anesthesia for Endobronchial Double Lumen Intubation in mediastinal masses and compromised airway.

关键词： Airway Management Difficult Airway Low Dose Ketamine Mediastinal Masses Subcutaneous Ketamine Subcutaneous Dissociative Conscious Sedation

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Complications in Head and Neck Surgery 2nd ed

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2009年

作者： David W. Eisele Richard V. Smith

ISBN: (纸本)9781416042204

Effectively avoiding, recognizing, and managing complications is integral to your operative success. Let a multidisciplinary team of experts in otolaryngology, plastic surgery, oral and maxillofacial surgery, and general surgery guide you through the full range of complications associated with every type of head and neck procedure . . . so you will be equipped to produce the most favorable outcomes for even the most challenging cases!

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Exteriorized colon anastomosis for unprepared bowel: An alternative to routine colostomy

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World Journal of Gastroenterology 2007年第23期13卷 3215-3220页

作者： Sami K Asfar Hilal M Al-Sayer Talib H Juma professor and chairman Department of Surgery Faculty of Medicine Kuwait University and Mubarak Al-Kabeer Hospital Safat-13110 Kuwait associate professor Department of Surgery Faculty of Medicine Kuwait University and Department of Surgery Ameri Hospital Kuwait Consultant Surgeon Department of Surgery Ameri Hospital Kuwait

AIM: To see the possibility of avoiding routine colostomy in patients presenting with unprepared bowel. METHODS: The cohort is composed of 103 patients, of these, 86 patients presented as emergencies (self- inflected and iatrogenic colon injuries, stab wounds and blast injury of the colon, volvulus sigmoid, obstructing left colon cancer, and strangulated ventral hernia). Another 17 patients were managed electively for other colon pathologies. During laparotomy, the involved segment was resected and the two ends of the colon were brought out via a separate colostomy wound. One layer of interrupted 3/0 silk was used for colon anastomosis. The exteriorized segment was immediately covered with a colostomy bag. Between the 5th and 7th postoperative day, the colon was easily dropped into the peritoneal cavity. The defect in the abdominal wall was closed with interrupted nonabsorbable suture. The skin was left open for secondary closure. RESULTS: The mean hospital stay (± SD) was 11.5 ± 2.6 d (8-20 d). The exteriorized colon was successfully dropped back into the peritoneal cavity in all patients except two. One developed a leak from oesophago- jejunostomy and from the exteriorized colon. She subsequently died of sepsis and multiple organ failure (MOF). In a second patient the colon proximal to the exteriorized anastomosis prolapsed and developed severe serositis, an elective ileo-colic anastomosis (to the left colon) was successfully performed. CONCLUSION: Exteriorized colon anastomosis is simple, avoids the inconvenience of colostomy and can be an alternative to routine colostomy. It is suitable where colostomy is socially unacceptable or the facilities and care is not available.

关键词： Colostomy Exteriorized colon Colon injury Colon anastomosis Unprepared colon Obstructing colon cancer Volvulus sigmoid

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腹部大动脉手术术后早期和迟发心肌梗塞

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国外医学（麻醉学与复苏分册） 2005年第3期26卷 184-188页

作者： Yannick Le Manach Azriel Perel Pierre Coriat Gilles Godet Michèle Bertrand Bruno Riou 马越涛王俊科 Resident in anesthesiology Department of Anesthesiology and Critical Care Sheba Medical Center Tel Aviv University Tel Hashomer Israel professor of anesthesiology and Critical Care and chairman (on sabbatical) Department of Anesthesiology and Critical Care Sheba Medical Center Tel Aviv University Tel Hashomer Israel professor of anesthesiology and Critical Care and chairman Staff Anesthesiologist Department of Anesthesiology and Critical Care professor of anesthesiology and Critical Care and Chairmn Department of Emergency Medicine and Surgery 中国医科大学第一临床学院麻醉科

背景:尽管有报道称血管手术术后心肌梗塞(PMI)与局部缺血时间过长有关,但其确切的病理生理机制还不十分清楚。

关键词：术后早期大动脉迟发腹部术后心肌梗塞病理生理机制缺血时间血管手术

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