RESUMEN
The aim of this study to evaluated blood coagulation profiles in 19 patients undergoing open-heart surgery with cardiopulmonary bypass (CPB). The patients were assigned to one of two groups, according to the type of oxygenator that was used: group A - membrane oxygenator (n=9); group B - bublle oxygenator (n=10). The blood samples for analysis of the clotting time (CT), activated partial thromboplastin time (APTT), prothrombin activity (PA), fibrinogen and platelet count were drawn at T0(pre-CPB) and T1(20 min after total neutralizing dose of protamine). A significant decrease in PA was observed in groups A and B (p less than 0.0001), with no significant differences between groups. The platelet count also decreased in both groups during CPB (p less then 0.0001), but no difference was observed between bubble and membrane oxygeenator patients. The other coagulation parameters were not affected significantly during CPB. This study shows that CPB with membrane or bubble oxygenator systems causes similar decreases in PA and platelet count
Asunto(s)
Humanos , Coagulación Sanguínea , Puente Cardiopulmonar , Oxigenación por Membrana Extracorpórea , OxigenadoresRESUMEN
The purpose of this study was evaluate the respiratory chnges of 24 ASA I OR II patients undergoing laparoscopic cholecystectomy under controlled mechanic ventilation. The anesthetic induction was performed with fentanyl (0.003-0.004 mg/kg), propofol (2-3 mg/kg), atracurium (0,5 mg/kg) and maintained with halothane and nitrous oxide (1:1). The respiratory pattern was adjusted to: tidal volume=10 ml/kg; respiratory rate= 10/min; I/E= 1/2. The endotracheal (PET) and intra-abdominal pressure,the oxygen saturation (SpO2) and end CO2 (PET CO2) were studied. These parameters were registred 1 minute after tracheal intubation (T0), 1 minute after insuflation of the peritoneal cavity (T1) and afterwards every 10 minutes. The oxygen saturation values were maintained within normal limits during the procedure. The endotracheal pressure increased significantly after insuflation of the peritoneal cavity (p=0,0001), while the values of the end tidal C02 incresead at T4 and T5, when compared with T0. The authors concluded that controlled mechanic ventilation along with an appropriate monitoring of the patient must be taken into account in order to prevent respiratory disturbances and its adverse effects
Asunto(s)
Humanos , Laparoscopía , Respiración Artificial , Pruebas de Función Respiratoria , Complicaciones IntraoperatoriasRESUMEN
O objetivo deste estudo foi verificar a proteção hemodinâmica conferida pelo alfentanil durante a laringoscopia e intubação traqueal, através de um estudo não comparativo. A dose de alfentanil (50 mg.kgúû). aqui estabelecida, foi uma tentativa de se fazer analogia à dose de fentanil necessária para a proteção hemodinâmica, durante essas manobras (cerca de 10 mg.hgúû). Como o alfentanil possui cerca de 1/5 da potência do fentanil, o valor foi de (50 mcg.kgúû). Entretanto, com esta dosagem não se observou bloqueio eficaz da estimulação autonômica, como pode ser observado nas Tabelas I, II e III. Verificaram-se aumentos importantes dos níveis pressórios e da frequência cardíaca após intubação em alguns pacientes. Se considerarmos a relação T4/T1, não se observaram alterações significantes da pressão sistólica, da pressão diastólica e da duração da laringoscopia e do número de tentativas de intubação em relação aos parâmetros observados, indicando proteção parcial da droga em relação aos reflexos da laringoscopia e intubação. Quanto às pressões arteriais sistólica, diastólica e frequência cardíaca, o alfentanil na dose de 50 mg.kgúû não conferiu proteção completa, promovendo aumentos percentuais, em média, de 16,83 ñ 19,45, 16,36 ñ 16,04 e 11,90 ñ 19,09, respectivamente.