1.The effects of different modes of mechanical ventilation under general anesthesia on children undergoing removal of foreign body with bronchofiberscopy
Kaiming FAN ; Zhenwei WAN ; Changke LI ; Yinlou YANG ; Bing CHEN
Journal of Chinese Physician 2015;17(7):1009-1012
Objective To explore the effects of different ventilation modes of tracheobronchial foreign body in children with fiberoptic operation under general anesthesia.Methods Sixty children (1ys≤ age≤3ys) undergoing fiberoptic bronchoscopy tracheal foreign body removal according to the combinations of different ventilation modes during and after fiberoptic bronchoscopy (FOB) procedures were divided into group A [volume control ventilation (VCV) + VCV,n =20],group B [pressure control ventilation (PCV) + VCV,n =20] and group C (PCV + PCV,n =20) randomly.The P mean,Pmax,and PetCO2 during and after fiberoptic bronchoscopy procedures were monitored.The SpO2,PaO2,and PaCO2 after mechanical ventilation 1.5 hours were recorded.Results Compared to group A,groups B and C had lower P max and P mean (P < 0.05) during the FOB procedures.Compared to groups A and B,group C had a lower P max and P mean (P <0.01) after the FOB procedures.At the 1.5 hours after the procedure,all the children showed significant increase in SpO2 and PaO2 (P < 0.05) and decrease in PaCO2 (P < 0.05) in groups A,B,and C.Conclusions When fiberoptic bronchoscopy in tracheobronchial foreign body operation is applied in children undergoing general anesthesia,the pressure control ventilation (VCV) mode can decrease the pressure of airway (Paw) and PaCO2 than volume control mode during procedure.
2.CT manifestation of lesser omentum invasion by gastric carcinaoma and the influence of lesser omentum on the gastric carcinoma spread
Meiying GE ; Huabin YIN ; Jingfang GE ; Kaiming WAN ; Zhonghui YU ; Hang JIN
Journal of Practical Radiology 2014;(5):786-789,807
Objective To investigate the CT manifestations of gastric carcinoma invasion to lesser omentum and to assess the im-pact of lesser omentum on the spreading of gastric carcinoma.Methods We retrospectively reviewed CT findings in 48 patients with gastric carcinoma and lesser omentum involved for primary tumor and the lesser omentum abnormalities.The influence of lesser o-mentum on the extension of gastric carcinoma as well as the accompanied ascites were also analyzed.Results CT manifestations of lesser omentum involvement in gastric carcinoma included the following items:① direct infiltration (35.4%,1 7/48),which was mainly shown as increased density of fatty tissue and the development of mass within the lesser omentum,including spreading into the liver through the lesser omentum directly in two cases;② omental seeding (25.0%,12/48),including smudged appearance (1 1 cases)and omental caking (1 case);③ metastasis of lymph nodes (64.6%,31/48),including enlargement and increase of lymph nodes (27 cases)and cystic mass (4 cases).Ascites was found in 1 1 patients and fluid collection in the lesser sac was shown in 3 of these 1 1 patients.The lesser omentum forms the anterior wall of the lesser sac and separates the fluid collection in the lesser sac from the ascites in the greater peritoneal cavity.Ascites was associated with the omental seeding statistically.Conclusion CT scan is helpful for detecting lesser omentum invasion by gastric carcinoma.The imaging features consist of mass sign,enlargement of lymph nodes,smudged andcakingappearance,and so on.Lesser omentum may also play a certain role in both the extension of gastric carcinoma and the compartmentalization of ascites due to gastric carcinoma.