No abstract available.
Holoprosencephaly*

BACKGROUND: Respiratory depression with high dose of propofol during induction is one of the major complications. We studied the effects of midazolam as premedicant on frequency and duration of apnea and frequency of loss of consciousness in relation to single dose of propofol. METHODS: We selected 194 adult patients who had clear consciousness and no depression of respiration. We allocated patients randomly to control group and midazolam group. In midazolam group, we injected 0.06mg/kg of midazolam intravenously 10min before induction, and in control group, we did nothing. Under mask oxygenation with 100% oxygen, we administered a bolus of propofol (1, 1.5, 2 mg/kg to subgroup 1, 2, 3 respectively) intravenously. The change of respiration and loss of consciousness were observed. RESULTS: The frequency and duration of apnea increased with the dose of propofol in both control and midazolam group. But there were no difference between groups except frequency of apnea with 1.5 mg/kg of propofol. In control group, frequency of loss of consciousness increased with the increasing dose of propofol. But in midazolam group, nearly all the patients was slept without difference by the dose. CONCLUSIONS: Premedication with midazolam reduce the sleeping dose of propofol to induce anesthesia, so the frequency and duration of apnea which is caused by high dose of propofol can be decreased.
Adult ; Anesthesia ; Apnea* ; Consciousness ; Depression ; Humans ; Masks ; Midazolam* ; Oxygen ; Premedication ; Propofol* ; Respiration ; Respiratory Insufficiency ; Unconsciousness*

No abstract available.
Hypertension ; Leigh Disease*

No abstract available.
Child* ; Heart Neoplasms* ; Humans

No abstract available.
Seizures*

No abstract available.
Suicide, Attempted*

BACKGREOUND: Cerebral damage caused by hemorrhagic shock presents an important challenge for critical care medicine. The type of fluid to resuscitate hemorrhagic shock is important for the outcome of such patients. Pentastarch is low-molecular-weight hydroxyethyl starch, which increases cerebral blood flow (CBF) by plasma volume expansion and compensatory vasodilation, and improves the microcirculation in the ischemic brain area by reducing the blood viscosity. METHODS: The authors continuously determined CBF and CMRO2 in 10 mongrel dogs weighing 20.1 +/- 0.8 kg with posterior sagittal sinus outflow method. Dogs were subjected to the 20 minute-period of hemorrhagic shock to a mean arterial pressure of 40 mmHg. The shock phase was followed by resuscitation with the same volume of 10% pentastarch as blood loss. The authors assessed the changes of CBF, CMRO2, and CBF/CMRO2 ratio immediately and 30, 60, 90, 120 minutes after pentastarch infusion. Brain water content was assessed by the wet-dry weight method. RESULTS: CBF was increased above the control level, immediately and 30 minutes after 10% pentastarch infusion (p<0.05), and approximated to the control level for the remaining time. CMRO2 was increased, immediately and 30, 60, 90 minutes after 10% pentastarch infusion (p<0.05), and approximated to the control level at 120 minutes. CBF/CMRO2 ratio was recovered to the control level after 10% pentastarch infusion. Brain water content was not significantly different from the normal value of dogs. CONCLUSION: 10% pentastarch may be used with safety to resuscitate hemorrhagic shock because it recovers the balance between the cerebral oxygen supply and demand, and does not cause cerebral edema.
Animals ; Arterial Pressure ; Blood Viscosity ; Brain ; Brain Edema ; Critical Care ; Dogs ; Humans ; Hydroxyethyl Starch Derivatives* ; Microcirculation ; Oxygen* ; Plasma Volume ; Reference Values ; Resuscitation ; Shock ; Shock, Hemorrhagic* ; Starch ; Vasodilation

BACKGROUND: Ischemia-reperfusion injury and ventilation/perfusion mismatch are the major complication of lung transplantation. Application of positive end-expiratory pressure(PEEP) on reperfused lung can prevent hypoxemia, because it increases functional residual capacity and improves oxygenation without contralateral dynamic hyperexpansion. To identify which differential lung ventilation with PEEP reduces ischemia-reperfusion lung injury, PaO2, intrapulmonary shunt, pulmonary compliance and water content of lung tissue were measured and compared with those of conventional two lung ventilation. METHODS: Nineteen Korean mongrel dogs were included for study. Double lumen endotracheal tube was inserted via tracheostomy site. Femoral arterial catheter and Swan-Ganz catheter were inserted for hemodynamic data and thoracotomy was done. The right pulmonary artery, vein, and main bronchus were clamped for 90 minutes and released to produce unilateral warm ischemia-reperfusion lung injury. In control group(C), conventional two lung ventilation was applied, and in experimental group(P), the right lung was ventilated with 10 cmH2O PEEP independent of the left lung. PaO2, intrapulmonary shunt, pulmonary compliance and water content of lung tissue were measured. RESULT: At 60 min after reperfusion, PaO2 in group P was higher than in group C(512.4+/-58.8 mmHg vs 263.6+/-165.8 mmHg), and intrapulmonary shunt was smaller(9.8+/-3.4 vs 25.9+/-11.3%). Dynamic and static pulmonary compliance in group P were higher than in group C(42.3+/-9.4, 95.2+/-14.7 vs 29.2+/-1.4, 60.2+/-17.1 dyne, sec/cm5). Water content of the right lung in group P was lower than in group C(81.1+/-1.6 vs 85.1+/-3.9%). CONCLUSION: In conclusion, these data suggest that application of positive end-expiratory pressure on reperfused lung is more effective to improve ventilation/perfusion mismatch and oxygenation, so it is thought to be a good treatment for ischemia-reperfusion lung injury.
Animals ; Anoxia ; Bronchi ; Catheters ; Compliance ; Dogs* ; Functional Residual Capacity ; Hemodynamics ; Lung Injury* ; Lung Transplantation ; Lung* ; Oxygen ; Positive-Pressure Respiration* ; Pulmonary Artery ; Reperfusion ; Reperfusion Injury ; Thoracotomy ; Tracheostomy ; Veins ; Ventilation*

BACKGROUND: Lung transplantation is the effective and the last treatment in the end-stage lung disease. But ischemia-reperfusion injury can not be avoidable in the lung transplantation. We have tried to make a unilateral warm ischemia-reperfusion model in dogs and measured the changes of the gas exchange, the hemodynamic variables and lung water content. METHODS: Ten Korean mongrel dogs (body weight 20.5+/-0.5 kg) were intubated with double-lumen endotracheal tube and Swan-Ganz catheter was inserted into left pulmonary artery via right internal jugular vein and then horizontal thoracotomy was done to expose both lungs. The right main pulmonary artery, vein and main bronchus were clamped simultaneously at the right hilum for 90 minutes after collapse of right lung during left side one lung ventilation. After 90 minutes clamping, two lung ventilation was started after declamping and reinflation of right lung. We measured hemodynamic variables and analysed arterial and mixed venous blood gases at the time of two lung ventilation (TLV), one lung ventilation (OLV), clamping 90 minutes, post-reperfusion 30 minutes and 60 minutes. Also we measured water content of both lung with wet-dry method. RESULTS: PaO2 decreased compared to TLV (514.5+/-67.1, vs 278.5+/-168.5 mmHg) and pulmonary vascular resistance (172.7+/-65.9 vs 241.6+/-99.3 dyne.sec/cm5) and Qs/Qt(15.2+/-6.7 vs 26.8+/-10.4%) was increased after reperfusion to right lung at 60 minutes . Lung water content of right lung was significantly increased compared to left lung (85.1+/-4.1% vs. 80.3+/-0.7%). Pathologic conditions showed interstitial edema, congestion of blood vessel and infiltration of neutrophils. Alveolar pink exudate and hemorrhage is also observed. CONCLUSION: Decrease of oxygenation, increase of intrapulmonary shunt, pulmonary vascular resistance and lung water with reperfusion to right lung suggests that the right lung has ischemia-reperfusion injury causing lung edema.
Animals ; Blood Vessels ; Bronchi ; Catheters ; Constriction ; Dogs* ; Edema ; Estrogens, Conjugated (USP) ; Exudates and Transudates ; Gases ; Hemodynamics* ; Hemorrhage ; Jugular Veins ; Lung Diseases ; Lung Transplantation ; Lung* ; Neutrophils ; One-Lung Ventilation ; Oxygen ; Pulmonary Artery ; Reperfusion ; Reperfusion Injury ; Thoracotomy ; Vascular Resistance ; Veins ; Ventilation

No abstract available.
Aorta* ; Pulmonary Artery*