Canadian Anaesthetists Research Articles

Canadian anaesthetists’ society prize

Canadian anaesthetists’ society prize

Canadian anaesthetists’ society prize

Canadian anaesthetists’ society prize

Canadian anaesthetists’ society annual meeting

Canadian anaesthetists’ society annual meeting

Canadian anaesthetists’ society prize

Canadian anaesthetists’ society prize

Canadian anaesthetists’ society annual meeting

Canadian anaesthetists’ society annual meeting

Canadian anaesthetists’ society prize

Canadian anaesthetists’ society prize

Canadian anaesthetists’ society prize

Canadian anaesthetists’ society prize

Canadian anaesthetists’ society prize

Canadian anaesthetists’ society prize

PULMONARY COMPLICATIONS AND CARDIOPULMONARY BYPASS

Presented at Canadian Anaesthetists' Society Annual Meeting, Vancouver, June, 1973. THE use of eardiopulmonary bypass and of the pump oxygenator has increased as newer surgical techniques have been developed. Pulmonary complications, particularly those of the left lower lobe, have remained frequent following bypass 1 despite the decrease in the post-perfusion syndrome or "pump lung" attributed to improved venting of the left ventricle and atrium s and/or the use of low molecular weight dextran? This study is an attempt to present the nature and frequency of these complications and to correlate these changes with pulmonary function during the first post-operative week. Pulmonary function was assessed using alveolo-arterial oxygen gradients (A-aDO2), arterio-alveolar carbon dioxide gradients (a-ADCO2), steady-state diffusing capacity for carbon monoxide (Dco.~.~), and physiological dead space-tidal volume ratios (VD/VT) in association with the roentgenologic changes. MATERIALS AND METHODS Nineteen patients were studied. They were clinically free of chest disease or overt uncontrolled congestive heart failure with the exception of one (case No. 11). Seventeen had coronary artery bypass grafts for refractory or intractable angina pectoris; one (No. 11) had mitral and aortic valve replacement because of refractory congestive heart failure and the remaining one (No. 15) had an aortic valve replacement. The clinical details are shown in Table I. All patients had cardiopulmonary bypass using a Sarns roller pump with the Bentley "Temptrol" reservoir and bubble oxygenator. Prime consisted of three units of heparinized homologous blood (3-5 days old) mixed with 1.5 to 2.0 litres of two-thirds 5 per cent G/W with one-third N/S. Blood flow was maintained at 9..2 liters/M s minute at 35 ~ C. with a minimum perfusion pressure of 60 mm Hg after adequate venting of left atrium and ventricle. During bypass the lungs were kept statically inflated with a mixture of nitrous oxide and oxygen 50:50 at 10 cm H20 pressure and humidified using an ultrasonic nebulizer. Three "sighs" were administered during most periods of bypass and again after the patient had come off bypass. The clinical and operative records were reviewed for factors which might have

Canadian anaesthetists’ society prize

Canadian anaesthetists’ society prize

Acupuncture analgesia in China.

A delegation of ten Canadian anaesthetists visited the People's Republic of China in April and May 1974 and observed 87 surgical and 19 dental operations under acupuncture analgesia. In 80% of the cases observed the analgesia appeared adequate for the conduct of the planned surgery. The utilization of acupuncture analgesia varied from hospital to hospital; surgeons and anaesthetists appeared to have confidence in using it in a limited number of planned surgical operations. The technique of induction varied from hospital to hospital, but a certain pattern became apparent; body needling was related to the site of operation and also based on ancient theories; using loci unrelated to the operative site, para-incisional needles were used to produce skin analgesia; ear needling alone was used in 19 cases and nose needling in one. No premedication was given for short cases and dental extractions. Most hospitals used electrical stimulation; in one institution needles were left in place during induction and throughout surgery without stimulation with equal results. A considerable degree of analgesia appeared to be present immediately post-operative and patients moved without concern for the operative site. It was felt that acupuncture analgesia represents n China an alternative to regional anaesthesia and that surgeons adapt their technique to the conscious patient in the operating room. It is essential that the patient cooperate and is prepared and motivated to withstand the emotional stress and unpleasant sensations associated with the surgery. Problems include inadequate suppression of visceral pain, lack of muscle relaxation and inadequate analgesia. In the author's opinion acupuncture analgesia has a very limited scope in our practice; it is time consuming and imposes considerable restrictions on the surgeon. However, the phenomenon is real and its investigation should contribute to a better understanding of the function of the nervous system.

Canadian anaesthetists' society prize.

Canadian anaesthetists' society prize.

Canadian Anaesthetists’ society

Canadian Anaesthetists’ society

Canadian anaesthetists’ society prize

Canadian anaesthetists’ society prize

Canadian Anaesthetists’ Society Prize

Canadian Anaesthetists’ Society Prize

Canadian anaesthetists’ society prize

Canadian anaesthetists’ society prize

Pulmonary complications and cardiopulmonary bypass: a clinical study in adults.

Presented at Canadian Anaesthetists' Society Annual Meeting, Vancouver, June, 1973. THE use of eardiopulmonary bypass and of the oxygenator has increased as newer surgical techniques have been developed. Pulmonary complications, particularly those of the left lower lobe, have remained frequent following bypass 1 despite the decrease in the post-perfusion syndrome or pump lung attributed to improved venting of the left ventricle and atrium s and/or the use of low molecular weight dextran? This study is an attempt to present the nature and frequency of these complications and to correlate these changes with pulmonary function during the first post-operative week. Pulmonary function was assessed using alveolo-arterial oxygen gradients (A-aDO2), arterio-alveolar carbon dioxide gradients (a-ADCO2), steady-state diffusing capacity for carbon monoxide (Dco.~.~), and physiological dead space-tidal volume ratios (VD/VT) in association with the roentgenologic changes. MATERIALS AND METHODS Nineteen patients were studied. They were clinically free of chest disease or overt uncontrolled congestive heart failure with the exception of one (case No. 11). Seventeen had coronary artery bypass grafts for refractory or intractable angina pectoris; one (No. 11) had mitral and aortic valve replacement because of refractory congestive heart failure and the remaining one (No. 15) had an aortic valve replacement. The clinical details are shown in Table I. All patients had cardiopulmonary bypass using a Sarns roller with the Bentley Temptrol reservoir and bubble oxygenator. Prime consisted of three units of heparinized homologous blood (3-5 days old) mixed with 1.5 to 2.0 litres of two-thirds 5 per cent G/W with one-third N/S. Blood flow was maintained at 9..2 liters/M s minute at 35 ~ C. with a minimum perfusion pressure of 60 mm Hg after adequate venting of left atrium and ventricle. During bypass the lungs were kept statically inflated with a mixture of nitrous oxide and oxygen 50:50 at 10 cm H20 pressure and humidified using an ultrasonic nebulizer. Three sighs were administered during most periods of bypass and again after the patient had come off bypass. The clinical and operative records were reviewed for factors which might have

Humidification of gas mixtures delivered by miniature ventilators

AnaesthesiaVolume 29, Issue 2 p. 191-193 Free Access Humidification of gas mixtures delivered by miniature ventilators D. B. WEEKS, D. B. WEEKS D. B. Weeks, MD, Assistant Professor of Anesthesia, The Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, North Carolina, and J. Chalon, MD, Assistant Professor of Anesthesiology, Albert Einstein College of Medicine of Yeshiva University, Bronx, New York, U.S.A.Search for more papers by this authorJ. CHALON, J. CHALON D. B. Weeks, MD, Assistant Professor of Anesthesia, The Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, North Carolina, and J. Chalon, MD, Assistant Professor of Anesthesiology, Albert Einstein College of Medicine of Yeshiva University, Bronx, New York, U.S.A.Search for more papers by this author D. B. WEEKS, D. B. WEEKS D. B. Weeks, MD, Assistant Professor of Anesthesia, The Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, North Carolina, and J. Chalon, MD, Assistant Professor of Anesthesiology, Albert Einstein College of Medicine of Yeshiva University, Bronx, New York, U.S.A.Search for more papers by this authorJ. CHALON, J. CHALON D. B. Weeks, MD, Assistant Professor of Anesthesia, The Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, North Carolina, and J. Chalon, MD, Assistant Professor of Anesthesiology, Albert Einstein College of Medicine of Yeshiva University, Bronx, New York, U.S.A.Search for more papers by this author First published: March 1974 https://doi.org/10.1111/j.1365-2044.1974.tb00622.xCitations: 2AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat References 1 Cohen, A.D. (1966) The Minivent respirator. Anaesthesia, 21, 563. 2 Collis, J.M., Bethune, D.W. & Tobias, M.A. (1969) Miniature ventilators. An assessment. Anaesthesia, 24, 81. 3 Carden, E. (1970) A simple portable ventilator for emergency resuscitation. Anesthesiology, 32, 269. 4 Chase, H.F., Trotta, R. & Kilmore, M.A. (1962) Simple methods for humidifying non-re-breathing anesthesia gas systems. Anesthesia and Analgesia: Current Researches, 41, 249. 5 Toremalm, N.G. (1961) Air-flow patterns and ciliary activity in the trachea after tracheotomy. Acta otolaryngologica, 53, 442. 6 Burton, J.D.K. (1962) Effects of dry anaesthetic gases on the respiratory mucous membrane. Lancet, i, 235. 7 Chalon, J., Loew, D.A.J. & Malebranche, J. (1972) Effects of dry anesthetic gases on tracheobronchial ciliated epithelium. Anesthesiology, 37, 338. 8 Noguchi, H. (1972) Studies on proper humidification in tracheotomized dogs. Nagoya Medical Journal, 17, 159. 9 Boys, J.E. & Howells, T.H. (1972) Humidification in anaesthesia. British Journal of Anaesthesia, 44, 879. 10 Weeks, D.B. & Broman, K.E. (1970) A method of quantitating humidity in the anesthesia circuit by temperature control: semiclosed circle. Anesthesia and Analgesia: Current Researches, 49, 292. 11 Mapleson, W.W., Morgan, J.G. & Hillard, E.K. (1963) Assessment of condenser-humidifiers with special reference to a multiple-gauze model. British Medical Journal, 1, 300. 12 Han, Y.H. & Lowe, H.J. (1961) Humidification of inspired air. Anesthesiology, 22, 135. 13 Sweeney, D.F. (1967) Artificial nose and aeromedical evacuation. American Review of Respiratory Diseases, 96, 1250. 14 Han, Y.H. & Lowe, H.J. (1968) Humidification of inspired air. Journal of the American Medical Association, 205, 907. 15 Dolorico, V.N., Chalon, J. & Weeks, D.B. (1974) A safely humidified non-rebreathing system. Anesthesia and Analgesia: Current Researches (in press). 16 Déry, R. (1973) The evolution of heat and moisture in the respiratory tract during anaesthesia with a non-rebreathing system. Canadian Anaesthetists' Society Journal, 20, 296. Citing Literature Volume29, Issue2March 1974Pages 191-193 ReferencesRelatedInformation

Canadian Anaesthetists' Society Prize

Canadian Anaesthetists' Society Prize

Canadian Anaesthetists' Society Annual Meeting 1973 Residents' Programme Prizes

Canadian Anaesthetists' Society Annual Meeting 1973 Residents' Programme Prizes