CPAP oxygenation during one-lung ventilation using an underwater seal assembly.
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Biomedical subjects
Publications and source records attributed to A Baraka.
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A T-piece injector assembly delivers a blended oxygen/air mixture proximally via the side-arm of the T-piece, while continuous positive airway pressure (CPAP) is independently regulated by an injector adapted distally to the open end of the reservoir tubing. The system can provide different CPAP levels without significant fluctuations in the airway pressure and/or the inspired oxygen concentrations, and it maintains the original simplicity and safety of the T-piece.
The report describes a new double lumen tube adaptor which provides selective one lung ventilation without external clamping. It also facilitates, without disconnexion and remantling, both correct bronchial cuff inflation and continuous positive airway pressure administration using an underwater seal chest bottle. Oxygenation can be kept optimal during one lung anaesthesia by applying 1.0 kPa continuous positive airway pressure to the nonventilated lung using an oxygen flow of 1-2 litres/minute.
The hemodynamic effects of vecuronium 0.2 mg/kg were investigated in 11 patients with coronary artery disease. Vecuronium, at a dose double the ED90, produced 90% neuromuscular block in a mean time of 163 +/- 7 s, and was not associated with any significant hemodynamic changes. The results suggest that vecuronium can safely be used in cardiac patients.
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Serum cholinesterase (E.C. 3.1.1.8) was assayed with succinylcholine as a substrate. The reaction was coupled with choline oxidase and peroxidase in the presence of 4-aminoantipyrine and phenol to produce a red quinone dye that was measured spectrophotometrically. The method requires 25 microliter of sample in a total volume of 1.0 ml. The mean activity for 35 adults of the usual genotype was 74.4 +/- 28 U/l (range 24-125 U/l). Succinylcholine-sensitive individuals had activities below 18 U/l. The same serum samples also were assayed with propionylthiocholine as a substrate. Activities with the two substrates showed a coefficient of correlation of 0.980 (n = 68). However, the method using propionylthiocholine showed more overlap between the activities of succinylcholine-sensitive and insensitive individuals. Assay with succinylcholine thus may offer a more effective method of screening for sensitive individuals, since some escape detection by conventional genotyping with dibucaine and fluoride.
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