It is considered that a portable oxygen source easy to tranport and manipulste is very useful in any emergency situation. The effect of a portable inhaler "O2-Pack" were studied by comparing the arterial blood gas analysis before and after transportation of patients in dividing two groups of each 20 patients from respiratory intensive care unit to surgical intensive care unit or ward. One group of 20 patients were not given the "O2-Pack" and another group of 20 patients was administered oxygen with the "O2-Pack" . The results were as follows: 1) There were no significant changes in arterial pH, PCO2 and HCO2(-) regardless of the use of the inhaler "O2-Pack" during transportation. 2) There were no significant differences in PaO2 before transportation between both groups. PaO2 of the after-transportation without "O2-Pack" compared with the before-transportation of the two groups and the aftertransportation using the "O2-Pack" during transportation. Considering the above results the authors conclude that the application of portable inhaler "O2-Pack" during transportation of critically ill patients is very useful in maintaining the adequate oxygen level in the arterial blood.
Blood Gas Analysis ; Critical Illness ; Emergencies ; Humans ; Hydrogen-Ion Concentration ; Critical Care ; Intensive Care Units ; Nebulizers and Vaporizers* ; Oxygen* ; Transportation ; Transportation of Patients

To evaluate the change of platelet function during pediatric open heart surgery, authors measured CBC(hemoglobin, hematocrit, platelet count), bleeding time, activated clotting time (ACT), and the degree of platelet aggregation immediately after induction(Tl), after arrival at intensive eare unit (ICU)(T2) and 24 hours after operation(T3) separately. The patients were devided into two groups; one group (7 patients, DHCA(-) group) was not undergone deep hypothermic circulatory arrest(DHCA) and the other group (7 patients, DHCA(+) group) was undergone DHCA. Authors analized the differences between two groups(intergroup) and between pre-CPB and post-CPB values(intragroup). The correlations between the degree of platelet aggregation and platelet count, body temperatue, period of cardiopulmonary bypass (CPB), and hleeding time were also analized respectively. The results were as follows, 1) The age, weight, body surface, and the nadir of body temperature during CPB, except the period of CPB, were significantly different between two groups. The average period of DHCA was 53.7+/-7.5 minutes. The average nadir of rectal and esophageal temperature were 17.2+/-1.1 degrees C and 14.0+/-0.9 degrees C in DHCA(+) group. 2) Intergroup and intragroup differences were not significant in hemoglobin and hematocrit. 3) Intragroup differences in platelet count were significant but intergroup difference were not significant. 4) The percent changes of platelet aggregation at T2 and T3 compared to the value at Tl were 70-80%, and 80-90% respectively. 5) The correlations between the degree of p1atelet aggregation and temperature, period of CPB, platelet count and bleeding time were poor, but bleeding time correlated with platelet count(r=0.6, P< 0.05).
Bleeding Time ; Blood Platelets* ; Body Temperature ; Body Weight ; Cardiopulmonary Bypass ; Ear ; Heart* ; Hematocrit ; Humans ; Platelet Aggregation ; Platelet Count ; Thoracic Surgery*

To determine the beta-sympatheitc activity of isoflurane and interaction between isoflurane and propranolol the study on cardiovascular effects in 8 dogs under various concentration of isoflurane anesthesia after intravenous injection of propranolol was undertaken. Heart rate, mean arterial pressure, central venous pressure, pumonary artery pressure, pulmonary capillary wedge pressure, and cardiac output were monitored and recorded under N2O-O2. N2O-O2-1 MAC of isoflurane, and N2O-O2-2 MCA of isofiurane, respectively and than at 20 minutes after wash;out with N2O-O2,and at 20 minutes after propranolol injection, and at 20 minute after the same conditioned anesthesia, above parameters were rechecked, respectively. Using above paramethers the cardiac index, stroke volume index, left ventricular stroke work index, systemic vascular resistance and pulmonry vascular resistance were calculated. Following results were obtained by comparing each data, and between isoflurane alone and isoflur- ane with propranolol injection.1) The heart rate, mean arterial pressure, cardiac output, cardiac index, left ventricular stroke index, systemic vascular resistance decreased significantly according to increment of isoflurane concentration. 2) The heart rate, mean arterial pressure, cardiac output, cardiac index and left ventricular stroke work index decreased significantly after injection of propranolol comparing with the data before injection and under same concentraion of isoflurane decreased significantly in the dogs pretreated with propranolol. 3) The stroke volume index did not change significantly with injection of propranolol but as adding isoflurane decreased significantly according to the concentration of isoflurane. 4) The pulmonary artery pressure did not change significantly with injection of propranolol but as adding isoflurane increased significantly comparing with that under the same concentration of isoflur-ane without propranolol. 5) The central venous pressure did not change significantly according to injection of propranolol or adding isoflurane. 6) The systemic vascular resistance and pulmonary vascular resistance increased significantly with injection of propranolol and adding isoflurane.
Anesthesia* ; Animals ; Arterial Pressure ; Arteries ; Cardiac Output ; Cardiovascular System* ; Central Venous Pressure ; Dogs ; Heart Rate ; Hemodynamics* ; Injections, Intravenous ; Isoflurane ; Propranolol* ; Pulmonary Artery ; Pulmonary Wedge Pressure ; Stroke ; Stroke Volume ; Vascular Resistance

Because of the increasing numbers of the operations requiring transfusions day by day, there is increase in transfusion reaction, and recently the shortage of blddd supply and the requirements for component transfusion are enhanced. In order to overcome the shortage of blood supply and to prepare the standard for com-ponent transfusion, the author compared the preoperative heraoglebin and hematocrit with postperative ones, and the conclusions are as followings. 1) There were no significant changes in hemoglobin and hematocrit of both male and female groups, as from preoperative values of 17.4+/-1.87g% and 42+/-5.0% to postoperative values of 14,2+/-1.79g% and 42+/-5.0% in male group, and from preoperative values of 12.8 +/-1.15 g% and 77+/-3.2% to postoperative values of 12.6+/-1.43g%, 37+/-4.0% in female group respectively. 2) There were no significant changes of hemoglobin and hematocrit according to the distributions of age and operating trite and the amount of b1ood transfusion. 3) There was significant decrease in hemoglobin of the transfusion group, but nut of the non-transfusion group, from 13.5+/-1. 59% to l3.3+/-1,73g%(P<0.05), but the practical sig- nificance of the change below 1.5% was considered negligible. 4) In the distribution of departments, there were significant changes in hemoglobin and hematocrit of obstetric gynecologic surgery from 12,8+/-1.24g%,37+/-3.3% to 12.3+/-1.44g%, 36+/-3.9% and hemoglobin of orthopedic surgery from 13.9+/-1.65g% to 13.2+/-1.88 g% respectively, but their practical significance of the changes in the range of 2 to 5% was also considered negligible. 5) There was significant change in hemoglobin of non cancer group, but not of cancer group from 13.6+/-1,65 g% to 13.4+/-1.75 g% (P<0.05) But the practical significance of the change under 1.5% was also considered negligible. From the about results, it is suggested that there are rooms for saving blood from curt-ailing transfusion of patients who were given one pint of blood only and even with multiple pints of blood, and also there are a great possibility for component transfusion after-wards but with slight limitation.
Blood Group Incompatibility ; Female ; Gynecologic Surgical Procedures ; Hematocrit* ; Humans ; Male ; Nuts ; Orthopedics

Propanidid was administered to 50 surgical patients, and the following results were obtained 1) Propanidid seemed effective as an induction agent. 2) Propanidid could be used alone or in combination with muscle relaxants. 3) Propanidid had little influence on the cardiovascular system, and caused no significant change in blood pressure. 4) Recovery was more rapid with propanidid than with other barbiturates. 5) Hiccough and involuntary movement were noted in the majority of patients. Vomiting, nausea, headache, shivering, and rash occurred in a few patients.
Barbiturates ; Blood Pressure ; Cardiovascular System ; Dyskinesias ; Exanthema ; Headache ; Hiccup ; Humans ; Nausea ; Propanidid ; Shivering ; Vomiting

Prostaglandin E1(PGE1) is a potent vasodillator of the systemic and coronary circulatory system, and when used in adult respiratory distress syndrome, PGE1 produces a decrease in pulmonary arterial pressure(PAP) and pulmonary vascular resistance(PVR), and increases cardiac output(CO) and arterial oxygen tension(PaO2). Another vasodilator hydralazine in patients with pulmonary hyertension and heart failure produces a decrease in PVR, and an increase in CO and inspite of an increase in CO, hydralazine maintains or increases the PaO2. The authors made a comparative studies on the effects of PGE1 and hydralarine on hemodynamics and gas exchange in experimentally induced acute lung injury. Oleic acid was infused in 8 dogs in order to induce acute lung injury and the effects on hemodynamics and gas exchange were measured every 30 minutes for 2hrs. After measuring Pre-PGE1 and Pre-hydralazine values, PGE1 and hydralazine were administered intravenously in order to evaluate and compare their effects. Doses for PGE1 and hydralazine were titrated until CO increased by 25%, heart rate(HR) increased by 15%, or mean arterial pressure(MAP) decreased by more than 20% from Pre-PGE1 and prehydralazine values. In PGE1 group, CO increased by 21%(p<0.01). MAP decreased by 14%(p<0.01). PVR decreased by 19%(p<0.01) and systemic vascular resistance(SVR) decreased by 29%(p<0.01). As CO increased with PGE1, intrapulmonary shunt(Qs/Qt) increased from 37% to 49%(p<0.01) and PaO2 fell from 109mmHg to 88mmHg(p<0.01). In hydralazine group, MAP, PVR, SVR and pulmonary capillary wedge pressure(PCWP) all decreased by 9%(p<0.01), 10%(p<0.05), 30%(p<0.0), 28%(p<0.01), respectively. CO increased by 41%(p<0.01) but the increase in Qs/Qt was only 5% inspite of a remarkable increase in CO, consequently PaO2 increased by 10% rising from 86mmHg to 94mmHg(p<0.01). Comparing the two groups, hydralazine resulted in a minor increase in Qs/Qt while there was a remarkable increase in CO. Moreover, it caused an increase in PaO2 and decrease in PCWP. The above results suggest that the effects of hydralazine are superior to those of PGE1 on the effects of hemodynamics and gas exchange in acute lung injury in dogs.
Acute Lung Injury* ; Alprostadil* ; Animals ; Capillaries ; Dogs ; Heart ; Heart Failure ; Hemodynamics* ; Humans ; Hydralazine* ; Lung Injury ; Oleic Acid* ; Oxygen ; Respiratory Distress Syndrome, Adult

The adverse cardiovascular effects of laryngoscopy and endotracheal intubation are well known. We compared the cardiovascular response of conventiomal tracheal intubation with that of newly developed Laryngeal Mask insertion in twenty-four ASA class I patients. Anesthesia was induced with injection of fentanyl 2 ug/kg, thiopental sodium 4 mg/kg and vecuronium 0.15 mg/kg intravenously. Ventilation was controlled for 5 minutes with inhalation of 50% nitrous oxide and 1 vo1% of isoflurane or 1.5 vol 8% of enflurane before tracheal intubation or laryngeal mask insertion in all patients. The patients are random1y assigned to either tracheal intubation group(ET group) or Laryngeal Mask group(LM group). After tracheal intubation or insertion of laryngeal mask, blood pressure(systolic, diastolic and mean) and heart rate were measured for 5 minutes at 1 minute interval. In all the parameter, cardiovascular response in ET group was significantly higher than that of LM group for 5 minutes after intubation. It is concluded that insertion of Larynaeal Mask is beneficial to a certain patients than use of laryngoscopy and tracheal intubation to avoid harmful cardiovascular respones in the management of airway during general anesthesia.
Anesthesia ; Anesthesia, General* ; Enflurane ; Fentanyl ; Heart Rate ; Hemodynamics* ; Humans ; Inhalation ; Intubation ; Intubation, Intratracheal* ; Isoflurane ; Laryngeal Masks* ; Laryngoscopy ; Masks ; Nitrous Oxide ; Thiopental ; Vecuronium Bromide ; Ventilation

In order to evaluate the ventilatory efficiency of the F-type breathing circuit, the authors compared the conventional anesthetic circuit using a 2-corrugated tube with the F-type breathing circuit through arterial blood gas analysis in 20 adult patients. There were no statistical differences between the two groups in arteral blood pH, PCO2 and PO2 and so the authors concluded that the F-type breathing circute could be substituted for the conventional anesthetic circuit using a 2-corrugated tube and even is superior in the case of head and neck surgery.
Adult ; Blood Gas Analysis ; Head ; Humans ; Hydrogen-Ion Concentration ; Neck ; Respiration

To evaluate historical trend, if any, anesthetic experiences of 23,385 in total performed at the Seoul National University Hospital from Jan. 1965 through Sept, 1972 were analyzed statistically according to age, sex, anesthetic agents and methods. The results are as follows: 1) General anesthesia has been used with increasing frequencies inversely to local anesthesia. 2) More than half the total cases were for the patients in the second or third decade of there ages. 3) The use of halothane has been steadily increasing ever since its introduction into clinical anesthesia in its country. 4) Thiopental has mainly been used for intravenous induction, and succinylcholine for facilitating endotracheal intubation. 5) In almost all cases semiclosed circle absorption system has been employed, and non-rebreathing system has recently been used with increasing favor for pediatric anesthesia.
Absorption ; Anesthesia ; Anesthesia, General ; Anesthesia, Local ; Anesthetics ; Halothane ; Humans ; Intubation, Intratracheal ; Seoul ; Succinylcholine ; Thiopental

To investigate the cardioyascular effects of 1 MAC-and 2 MAC-isoflurane anesthesia, eight Mongrel dogs were anesthetized with intravenous thiopental sodium and maintained with endotracheal nitrous oxide (2 l/min) -oxygen(2 l/min) -isoflurane-pancuronium. Dogs were kept normothermic by the use of Aqua-Therm and normocapneic with controlled ven-tilation employing Airshield Ventimeter with frequent measurements of PaCO2. An 18G Medicut was inserted in the left femoral artery, a Swan Ganz catheter was passed into the pulmonary artery through the right femoral vein, and cardiovascular parameters were measured during control, 1 MAC-and 2 MAC isoflurane administration. The results are as follows : 1) Heart rate, mean arterial pressure, cardiac output, cardiac index, stroke volume, left ventricular stroke work index and left ventricular dp/dt max decreased during both MAC isoflurane anesthesia. These decreases were more prominent during 2 MAC-isoflurane administration. 2) Pulmonary capillary wedge pressure and pulmonary vascular resistance did not change significantly during the 1 MAC phase, but did during the 2 MAC phase. 3) Mean pulmonary arterial pressue decreased slighter during both phases. 4) Central venous pressure and srstemic vascular resistance did not change significantly throught the experiment. The above findings indicate that isoflurane does directly depress the myocardium and the hemodynamic function, and it is important to decrease isoflurane concentration acccordingly with the use of nitrous oxide.
Anesthesia ; Animals ; Arterial Pressure ; Cardiac Output ; Catheters ; Central Venous Pressure ; Dogs* ; Femoral Artery ; Femoral Vein ; Heart Rate ; Hemodynamics ; Isoflurane* ; Myocardium ; Nitrous Oxide ; Pulmonary Artery ; Pulmonary Wedge Pressure ; Stroke ; Stroke Volume ; Thiopental ; Vascular Resistance