ABSTRACT
OBJECTIVE: Evaluate whether exhaled nitric oxide may serve as a marker of intraoperative bronchospasm. INTRODUCTION: Intraoperative bronchospasm remains a challenging event during anesthesia. Previous studies in asthmatic patients suggest that exhaled nitric oxide may represent a noninvasive measure of airway inflammation. METHODS: A total of 146,358 anesthesia information forms, which were received during the period from 1999 to 2004, were reviewed. Bronchospasm was registered on 863 forms. From those, three groups were identified: 9 non-asthmatic patients (Bronchospasm group), 12 asthmatics (Asthma group) and 10 subjects with no previous airway disease or symptoms (Control group). All subjects were submitted to exhaled nitric oxide measurements (parts/billion), spirometry and the induced sputum test. The data was compared by ANOVA followed by the Tukey test and Kruskal-Wallis followed by Dunn's test. RESULTS: The normal lung function test results for the Bronchospasm group were different from those of the asthma group (p <0.05). The median percentage of eosinophils in induced sputum was higher for the Asthma [2.46 (0.45-6.83)] compared with either the Bronchospasm [0.55 (0-1.26)] or the Control group [0.0 (0)] (p <0.05); exhaled nitric oxide followed a similar pattern for the Asthma [81.55 (57.6-86.85)], Bronchospasm [46.2 (42.0 -62.6] and Control group [18.7 (16.0-24.7)] (p< 0.05). CONCLUSIONS: Non-asthmatic patients with intraoperative bronchospasm detected during anesthesia and endotracheal intubation showed increased expired nitric oxide.
Subject(s)
Adolescent , Adult , Female , Humans , Male , Middle Aged , Young Adult , Anesthesia/adverse effects , Bronchial Spasm/chemically induced , Exhalation/drug effects , Inflammation Mediators/analysis , Intraoperative Complications/chemically induced , Nitric Oxide/analysis , Analysis of Variance , Anesthesia, Inhalation , Asthma/diagnosis , Bronchial Spasm/diagnosis , Bronchodilator Agents/adverse effects , Bronchodilator Agents/analysis , Case-Control Studies , Eosinophils , Inflammation Mediators/adverse effects , Nitric Oxide/adverse effects , Spirometry , Sputum/chemistry , Young AdultSubject(s)
Humans , Female , Pregnancy , Infant, Newborn , Asphyxia Neonatorum/complications , Algorithms , Leukomalacia, Periventricular/etiology , Chorioamnionitis/complications , Surveys and Questionnaires , Chorioamnionitis/physiopathology , Interleukin-6 , Obstetric Labor Complications/diagnosis , Obstetric Labor Complications/prevention & control , Malpractice , Inflammation/complications , Inflammation Mediators/adverse effects , Cerebral Palsy/etiology , Self-Evaluation Programs , Uterus/physiopathologyABSTRACT
El síndrome de falla múltiple de órganos (SFMO) es un problema común en las UTIs. En su generación intervienen múltiples agentes tóxicos. El intestino parece ser una fuente importante de los mismos ya que es particularmente sensible a la isquemia y reperfusión. De hecho el acoplamiento DO2-VO2 se observa antes que en el resto del organismo. Esto lo convierte en un gatillo de lesión a distancia, permitiendo el paso de mediadores a la circulación general con reinicio sistémico del ciclo liberación-lesión
Subject(s)
Humans , Alprostadil/adverse effects , Endotoxins/adverse effects , Free Radical Scavengers/adverse effects , Interleukin-1/adverse effects , Interleukin-2/adverse effects , Intestine, Small/blood supply , Multiple Organ Failure/physiopathology , Reperfusion , Reperfusion Injury/physiopathology , Thromboxane A2/adverse effects , Tumor Necrosis Factor-alpha/adverse effects , Splanchnic Circulation/physiology , Free Radicals/adverse effects , Free Radicals/classification , Inflammation Mediators/adverse effects , Reperfusion Injury/complications , Reperfusion Injury/etiology , Superoxide Dismutase/pharmacologyABSTRACT
El síndrome de disfunción (falla) orgánica múltiple es diagnosticado cada vez con más frecuencia en todo el espectro etario. La sobrevida lograda con los avances en las técnicas de resucitación de shock, sepsis y trauma se ha visto acompañada de una mayor incidencia de esta entidad. A pesar de casi una década de su descripción en niños y de su importancia existen muy pocas publicaciones en pediatría. Inicialmente se pensaba que el síndrome era sinónimo de complicaciones infecciosas y/o trauma. La caracterización de esta enfermedad, la importancia del "huésped" en la fisiopatología y manifestaciones clínicas del síndrome, el cuadro clínico, los principios terapéuticos, la prevención y su pronóstico son analizados en detalle en una revisión extensa de la literatura