RESUMO
One hundred adult patients, undergoing elective open heart surgery over a period of 4 months, were studied to assess the practice of ventilation in the post operative period. The anaesthetic technique employed used moderate doses of morphine, supplemented with halothane and a muscle relaxant. The decision to extubate was based on clinical assessment, and satisfactory blood gases following a 45 minute T-piece trial. The patients were ventilated for an average duration of 8 hours and 2 minutes and 59 out of 100 patients were extubated within 8 hours. Patients undergoing coronary artery bypass graft were ventilated for significantly longer durations (10 hours 28 minutes) (p < 0.05) and had significantly lower arterial oxygen tension (p < 0.01) 30 minutes after extubation, as compared with those undergoing valvular surgery. Also patients whose bypass time exceeded 2 hours had significantly longer extubation times (p < 0.05) as compared with those who had a bypass time less than 1 hour. T piece trial was found to be a satisfactory method of weaning in all the patients.
Assuntos
Adulto , Valva Aórtica/cirurgia , Ponte de Artéria Coronária , Doença das Coronárias/cirurgia , Feminino , Doenças das Valvas Cardíacas/cirurgia , Próteses Valvulares Cardíacas , Hemodinâmica/fisiologia , Humanos , Ventilação com Pressão Positiva Intermitente , Masculino , Pessoa de Meia-Idade , Valva Mitral/cirurgia , Cuidados Pós-OperatóriosRESUMO
A total of 476 internal jugular vein cannulations performed between June 1990 to August 1991 were prospectively evaluated. The patients' age ranged between ten days to 61 years. We achieved a high success rate of cannulation (97.9%). We describe the use of two single lumen catheters inserted through right internal jugular vein as an alternative to the popular multilumen catheters. We also suggest that low approach should be tried more often in children, if the central approach fails.