Biomedical subjects

L Olmedilla Arnal

Publications and source records attributed to L Olmedilla Arnal.

5 recordsLinked to original sources

PubMed2003

Cardiac output by femoral arterial thermodilution-calibrated pulse contour analysis during liver transplantation: comparison with pulmonary artery thermodilution.

PURPOSE: The continuous monitoring of the cardiac output during liver transplantation (LT) is an essential part of the intraoperative management of the patient's hemodynamics. To verify the accuracy of a new method based on femoral artery thermodilution-calibrated pulse contour analysis (PCCO) during LT, we compared the technique with the results of an intermittent pulmonary artery thermodilution method (ICO). METHOD: A prospective study included 314 paired cardiac output measurements at 10 sampling times in 35 patients undergoing LT. After initial calibration of the pulse contour analysis, no further recalibrations were performed. Bland and Altman's statistical method, one-way ANOVA, and one sample t tests were used for the analysis of the data. A P<.05 was considered significant. RESULTS: There was a small bias 0.18 L x min(-1) (6.29% from the ICO) for the whole sample of paired measurements, associated with 95% limits of agreement of +/-4.72 (68.89%) L x min(-1). The additional analysis showed comparable biases and limits of agreement for any single time in the study period. The difference PCCO-ICO showed a negative sign for ICO >10 L x min(-1) (P<.001) and a positive sign for ICO <5 L x min(-1) (P<.001). It was greater during infusion of a vasoactive drug (P<.001). CONCLUSION: The pulse contour analysis was found to be an unsatisfactory substitute for intermittent thermodilution measurement of cardiac output during the LT.

Analysis of Variance↗

PubMedDate not supplied

[Effect of an intravenous nitroglycerin bolus on the hemodynamic impact of laryngoscopy and intubation].

The aim of this study was to evaluate the effectiveness of intravenous administration of a single dose of nitroglycerin in lessening the hemodynamic effects induced during laryngoscopy and tracheal intubation. In an initial subset of 8 patients we verified that the hemodynamic changes after an intravenous dose of 2, 5, or 10 micrograms/kg of nitroglycerin were comparable. The study included 30 patients with a good clinical condition who were anesthetized with fentanyl, thiopental sodium and succinylcholine. They were allocated into two groups of 15 patients according to the intravenous administration or not of 2 micrograms/kg of nitroglycerin after induction of anesthesia. Increase in systolic blood pressure (SBP) and double product (SBP x heart rate) during laryngoscopy and 15, 30, and 45 seconds thereafter was significantly lower in nitroglycerin treated patients than in controls. Increase in diastolic blood pressure was also lower in nitroglycerin treated patients but this difference was only present during laryngoscopy. There were no significant heart rate differences among the two groups of patients. It is concluded that a single intravenous dose of 2 micrograms/kg of nitroglycerin was able to lessen the increase in blood pressure induced by laryngoscopy and tracheal intubation without deleterious effects.

Adult↗

PubMedDate not supplied

[Massive transfusion: methods and complications].

Massive blood transfusion is a therapeutic procedure increasingly common in anesthesiologic practice. In the present study we reviewed the literature on cellular changes and biochemical abnormalities developing in the blood components during storage. We also reviewed the different methods for infusion and the flow achieved depending on the type of intravenous catheter, infusion system, pressure methods, characteristics of the fluid, and type of filter. We also assessed the pathophysiology of the complications of massive blood transfusion: abnormalities of coagulation, metabolism, oxygen transportation, pulmonary function, hemodynamics and erythrocyte shape, plasma proteins denaturalization, toxicity of plastic products and hypoglycemia.

Blood Preservation↗

PubMedDate not supplied

[Pulmonary atelectasis in bent lateral decubital position (nephrectomy). Apropos of a case].

Here we have the case of a right nephrectomy ureterectomy for urothelial neoformations in the upper urinary apparatus, in the position of a left flexed lateral decubitus (nephrectomy) practised to a patient, in which a small right pleural aperture was unnoticed until the end of the operation when the closing was being carried out. In the immediate postoperative, the patient developed hypoxia and hypercapnia, as well as an atelectasis of the lower lobus in the left lung, that appeared in the radiological test. We comment now the causes that could have originated this picture, such as overweight, the position of the patient during the operation, its length and the pleural aperture throughout the surgical act, focusing the study in this latter point.

Humans↗

PubMedDate not supplied

[Anesthesiology implications of laparoscopic surgery].

Laparoscopic surgery is constantly advancing and has produced a small revolution in how surgery is used in a range of abdominal disease. Against the undisputed advantages laparoscopy brings to surgery (shorter hospital stay, rapid return to normal activity, more comfortable postoperative recovery and so on), we must weight its technical and anesthetic limitations, as well as the possibility of associated complications. At this time, appropriate indications for applying this technique in preference to conventional surgery are still in the process of being established. The solution to this very recently posed problem will come as a result of further developments in laparoscopic procedures, greater experience and larger studies of morbidity and mortality. It seems clear that in spite of their advantages, surgical techniques involving minimal abdominal incisions will be the subject of controversy and debate for some time to come.

Anesthesia↗