ABSTRACT
To evaluate the relationship between spontancous diuresis and improvement of pulmonary function in respiratory distress syndrome, 15 premature neonates requiring mechanical ventilation for RDS, who admitted in NICU of Wonkwang University Hospital from January 1990 to June 1992, were studied. The results were as follows (results are mean+/-SEM) 1) Mean birth weight of study infants was 1.82+/-0.08Kg, and mean gestational age was 32.80+/-0.54 weeks. 2) The onset of diuresis occured at a mean age of 29.1+/-2.48 hours with maximum diuresis at a mean age of 41.9+/-1.8 hours 3) Mean urine output increased from 2.25+/-0.43ml/Kg/hr at the stage of pre 12 hours-onset of diuresis (p<0.001), then decreased 3.5+/-0.2ml/Kg/hr at the stage of after maximum diuresis (p<0.05). 4) After maximum diuresis, inspired oxygen gradient, peak inflating pressure, peak end expiratory pressure, mean airway pressure, and respiratory rate were decreased significantly (p<0.05), and alveolar-arterial oxygen gradient was decreased more significantly (p<0,01). So, We conclude that the pulmonary function was rapidly improving after maximum diuresis and these changes reflect the general principle used in ventilatory management of infants with RDS.
Subject(s)
Humans , Infant , Infant, Newborn , Birth Weight , Diuresis , Gestational Age , Oxygen , Respiration, Artificial , Respiratory RateABSTRACT
In order to assess the interaction between halothane and diltiazem on the cardiovascular system and oxygenation, eight mongrel dogs were instrumented so that the following measurements could be made under the influence of drugs heart rate(HR), mean arterial pressure(MAP), central venous pressure(CVP), pulmonary arterial pressure(PAP), pulmonary capillary wedge pressure(PCWP), hemoglobin(Hb) and cardiac output(CO). Systemic and pulmonary vascular resistance(SVR and PVR), coronary perfusion pressure(CPP), cardiac index(CI), oxygen transpor(O2 Flux), oxygen consumption VO2, oxygen extraction ratio(O2ER) and intrapulmonary shunt(Qs/Qt), etc, were calculated by using the above measured parameters. Infusion of diltiazem (8ug/kg/min) following an IV bolus of 0.2mg/kg resulted in a potent vasodilator effect with significant decreases in MAP and SVR, and an increase in CI. Importantly, however, the systemic vasodilator effect of diltiazem was associated with no significant compensatory increase in HR. Halothane anesthesia during continuous infusion of diltiazem produced dose related decrease in HR, CI, MAP, CPP, RPP and O2 Flux, but the previously decreased SVR by diltiazem was not affected by halothane. PCWP, CVP and PVR were not changed throughout the study. So halothane anesthesia during infusion of diltiazem might have some dose related direct negative inotropic and chronotropic effects. Because the decrease in oxygen demand-indicating parameters such as HR and RPP was greater than that in oxygen transport (O2 Flux), the combined use of halothane and diltiazem can be recommended for the patient with ischemic heart disease and angina pectoris, especially in the therapy for decreasing heart rate.
Subject(s)
Animals , Dogs , Humans , Anesthesia , Angina Pectoris , Capillaries , Cardiovascular System , Diltiazem , Halothane , Heart , Heart Rate , Hemodynamics , Myocardial Ischemia , Oxygen Consumption , Oxygen , PerfusionABSTRACT
The effects of oral premedication with diazepam and atropine were evaluated. We made three kinds of syrup which were composed of diazepam 0.3mg/0.5cc, diazepam 0.3 mg mixed with atropine 0.001 mg in 0.5cc and diazepam 0.3mg mixed with atropine 0.03mg in 0.5cc, respectively. The 1st was administered to Group l (n=21), the second to group ll (n=21) and the last to group lll (n= 24) one and half to two hours before induction of anesthesia. Each child received 0.5 cc/kg. On arrival at pediatric operating room, anxiety levels, vital signs, antisalivatory effect and side effects were checked. The attitude of children was evaluated just before induction of anesthesia. In group land lll, slight elevation of diastolic blood pressure was noticed. The satisfaotory levels, checked by anxiety level O, were 86% in group l, 90% in group ll and 79% in group lll. The altitudes in the operating rooms just before induction of anesthesia were satisfactory and cooperative in 77 %, 81%, and 87% of patients in group l, ll and lll, respectively. Antisalivatory effect was not good in group l, but satisfactory in 82% and 75% of cases in group ll and lll. But side effect was present in 25% of cases in group ll and lll, in spite of 10% in group l. So we can conclude that preoperative oral diazepam in a dose of 0.3mg/0.5cc/kg is very good for the reduction of anxiety and the additiopn of atropine may increase the incidence of side effects. Threefore we recommend parentreral belladonna alkaloids just before induction instead of preoperative oral medication.
Subject(s)
Child , Humans , Altitude , Anesthesia , Anxiety , Atropine , Belladonna Alkaloids , Blood Pressure , Diazepam , Incidence , Operating Rooms , Premedication , Vital SignsABSTRACT
The cardiac pacemaker has been implanted for patients with debilitating low cardiac output associated heart block. Modern technology has provided advanced, controllable and simple cardiac pacemakers throughout the world. The patient with a cardiac pacemaker implanted could give anestheaiolgists many associated problems during the operation and anesthesia. During anesthesia an anesthesiologist should be able to manage the problems which might occur because of a cardiac pacemaker by varicus origins. Authors have experienced a case of open reduction for malunioned femur fracture with a cardiac pacemaker implanted.
Subject(s)
Humans , Anesthesia , Cardiac Output, Low , Femur , Heart BlockABSTRACT
The cardiac pacemaker has been implanted for patients with debilitating low cardiac output associated heart block. Modern technology has provided advanced, controllable and simple cardiac pacemakers throughout the world. The patient with a cardiac pacemaker implanted could give anestheaiolgists many associated problems during the operation and anesthesia. During anesthesia an anesthesiologist should be able to manage the problems which might occur because of a cardiac pacemaker by varicus origins. Authors have experienced a case of open reduction for malunioned femur fracture with a cardiac pacemaker implanted.