Adult Respiratory Distress Syndrome Following Trauma - Case report / 대한마취과학회지

Adult respiratory distress syndrome(ARDS) is described under various names in the medical literature: post-traumatic pulmonary insufficiency, wet lung. DaNang lung and shock lung etc., and the syndrome has been used to describe a serious and often fatal conditions which may develop in any patient subjected to severe trauma, major surgery or critical illness. ARDS is characterized by increasing intrapulmonary shunting, increasing work of breathing and decreasing lung compliance. There is still desagreement about exact nature of ARDS as well as its care and revention. In ARDS, the use of positive end-expiratory pressure(PEEP) has been widely debated since its introduction by Ashbaugh and Petty in 1969. Its purpose is to increase the lung volume, especially functional residual capacity at end expiration in order to obtain better alveolar expansion and improved pulmonary gas exchange. This report described two cases of ARDS following trauma, and respiratory care problems were reviewed and discussed.

The Effect of Ketamine on the Isolated Smooth Muscle of the Rabbit / 대한마취과학회지

Ketamine hydrochlaride, chemically related to both pencyclidine and cyclohexamine, is a new nonbarbiturate intravenous anesthetic agent. Clinical investigations were begun in 1965 by Domino and associates, who first used the term "dissociative anesthesia" . Anesthesia induced by ketamine dissimilar to that resulting from the more widely used intravenous or gaseous componds. Because of its minimal depressant effect on the cardiovascular and respiratory systems as well as its dissociative effect on the central nervous system ketamne bas achieved widespread use. However there have been few reports on its effect an intestinal motility. The present study was undertaken to determine the effect of ketamine on doudenal motility and on other smooth muscles of the rabbit. Strips of various isolated smooth muscle, 2 cm long from adult rabbits weighing about 2 kg, were suspended in a muscle chamber containing Tyrode's solution, which was bubbled with oxygen gas, and the solution was kept constant at 38C. Contraction of the preparations was recorded on polygraph (Grass, mode17). After being washed several times with fresh solution, the smooth muscle strips attained constant motility and tonus. Ketamine and other drugs were added in various concentrations to the chamber. The results areas follows: 1) Ketamine relaxed the isolated rabbit duodenag strip and potentiated the relaxing effect of epinephrine, norepinephrine and isoproterenol. 2) The relaxing effect of ketamine on isolated duodenal strip of rabbits was not abolished by the adrenergic blocking agents, but ketamine antagonized histamine or serotonin-induced contra ction. 3) Ketamine did not exert any effect on the isolated auricle, aorta, trachea, trigone and detrusor muscle strips of rabbit. From the results described above, it may be concluded that ketamine exerts a depressant effect on the isolated duodenal smooth muscle of rabbits without relation to adrenergic receptors.

Indirect Estimation of Arterial Po2 and pH during General Anesthesia / 대한마취과학회지

Many attempts have been made to device a simple, yet accurate, laboratory method to evaluate the ventilation and acid-base disorders in patients. This study compares the values for Pco2, pH and Po2 of blood samples drawn simultaneously from a radial artery and a vein on the back of the other hand during general anesthesia in 62 cases. The mean arterial and mean venous Pco2 and pH differences were 0. 924 torr and 0. 00013. These differences were too small to be of clinical importance and also varies slightly dependent on the main anesthestics used. Therefore we feel that the use of peripheral venous blood for pH and Pco2 determination during general anesthesia is a reliable indirect method of arterial Pco2 and pH.