ABSTRACT
To compare the rate of success and incidence of complications associated with currently popular routes of percutaneous central venous cannulation, we studied 131 patients in whom central venous catheterization was attempted. Right or left external jugular veins were used in 67 cases, and success rate was 9796. Right internal jugular veins were used in 27 cases, and success rate was 100%. Right or left basilic veins were used in 21 cases, and success rate was 76%. Right or left subclavian veins were used in 16 cases, and 75% of success rate. Non-J-wire type catheters were utilized in 60 cases, and success rate was 88%. J-wire type catheters were used in 71 eases, and success rate was 94%. We found 2 cases of catheter curling in Non-J-wire type catheters.
Subject(s)
Humans , Catheterization , Catheterization, Central Venous , Catheters , Central Venous Catheters , Incidence , Jugular Veins , Ocimum basilicum , Subclavian Vein , VeinsABSTRACT
The purpose of this study was to determine the frequency and severity of arterial oxygen desaturation during and after endotracheal suctioning in a group of ventilator-dependent patients and to evaluate the efficacy of several maneuvers designed to minimize desaturation. All patients were ventilated with volume-typed ventilator and a synchronized intermittent mandatory ventilation(SIMV) mode was utilized. In a given patint, each study consisted of four seperate passes of the suction catheter. The oxygen status of the patient was monitored with a digital pulse oxymeter. The mean baseline SaO2 for the group with each suctioning technique was very similar and did not differ significantly. When patints were suctioned off the ventilator without extra breaths, a significant drop occurred in the mean SaO2 And when the patients were suctioned with prebreaths and postbreaths off the ventilator or were maintained on the ventilator and suctioned through the swivel adaptor, there was a significant desaturation with all three methods. However, the mean desaturation of 0.8 percent with the swivel adaptor was significantly less(p<0.05) than the mean desaturation with any of the other three methods.
Subject(s)
Humans , Catheters , Oxygen , Suction , Ventilators, MechanicalABSTRACT
The selection of either conventional mechanical ventilation or HFJV depends on the physical status of the patient,potential physioloic advantages and disadvantages, the requirements of the clinical situation and the capability of providing adequate oxygenation and ventilation. We have experienced that HFJV markedly improved the ventilatory status of a 52-year old male patient with severe respiratory failure due to flail chest and ruptured giant bulla refractory to conventional mechanical ventilatory support.
Subject(s)
Humans , Male , Middle Aged , Hypoxia , Flail Chest , High-Frequency Jet Ventilation , Oxygen , Respiration, Artificial , Respiratory Insufficiency , VentilationABSTRACT
The selection of either conventional mechanical ventilation or HFJV depends on the physical status of the patient,potential physioloic advantages and disadvantages, the requirements of the clinical situation and the capability of providing adequate oxygenation and ventilation. We have experienced that HFJV markedly improved the ventilatory status of a 52-year old male patient with severe respiratory failure due to flail chest and ruptured giant bulla refractory to conventional mechanical ventilatory support.
Subject(s)
Humans , Male , Middle Aged , Hypoxia , Flail Chest , High-Frequency Jet Ventilation , Oxygen , Respiration, Artificial , Respiratory Insufficiency , VentilationABSTRACT
A 39 years old, ASA PS I. healthy female patient was scheduled for surgical resection of a paraganglioma surrounding right carotid artery bifurcation area. Anesthesia was induced with thiopental and sucinylcholine and maintained with 0.75-1.25 Vo1% halothane in 50% nitrous oxide in oxygen. Reconstructive carotid artery surgery with intraluminal shunt was performed due to laceration of carotid artery bifurcation area during wide dissection of tumor mass. Duration of the carotid artery clamp and release was 35 minutes and any significant changes in vital signs and EEG were not found. Soon after the patient was recovered from anesthesia. She was delivered to recovery room and then she was transferred to intensive care unit. She was discharged from hospital without any neurologic sequelae on the 13th postoperative day.