Seminars in anesthesia最新文献_第9页

Seminars in anesthesia Pub Date : 2005-09-01 DOI: 10.1053/S0277-0326(05)00052-8

引用次数: 0

Professionalism and interpersonal communications: ACGME competencies and core leadership development qualities. Why are they so important and how should they be taught to Anesthesiology Residents and Fellows? 专业精神和人际沟通:ACGME能力和核心领导力发展品质。为什么它们如此重要?如何向麻醉科住院医师和研究员传授这些知识?

Seminars in anesthesia Pub Date : 2005-09-01 DOI: 10.1053/j.sane.2005.07.006

Patrick Lattore MSEd, PhD , Philip D. Lumb MB, BS (FCCM)

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引用次数: 15

Systolic pressure variation: a dynamic measure of the adequacy of intravascular volume 收缩压变化:血管内容积充分性的动态测量

Seminars in anesthesia Pub Date : 2005-09-01 DOI: 10.1053/j.sane.2005.07.003

Pema Dorje MD, Kevin K. Tremper MD

{"title":"Systolic pressure variation: a dynamic measure of the adequacy of intravascular volume","authors":"Pema Dorje MD, Kevin K. Tremper MD","doi":"10.1053/j.sane.2005.07.003","DOIUrl":"https://doi.org/10.1053/j.sane.2005.07.003","url":null,"abstract":"<div><p><span>Central venous pressure and </span>pulmonary artery occlusion pressure<span><span> measurements are complicated by ventilatory changes in intrathoracic pressure and have a poor record as a preload parameter. The hemodynamic changes of </span>mechanical ventilation<span> have the effect of withholding a volume of blood and then giving it back during each respiratory cycle. The inspiratory phase of mechanical ventilation reduces preload and increases afterload of the right heart, while the preload is increased and afterload is reduced. These changes are reversed during expiration. The systolic pressure variation (SPV) by mechanical ventilation is closely related to the intravascular volume according to Starling’s law. The effect of mechanical ventilation on the left ventricular stroke volume has given birth to dynamic monitors of preload obtained from the arterial side in the form of SPV and pulse pressure variation. Animal studies and numerous clinical studies in surgical and critically ill patients have shown the superiority of dynamic monitors over the venous and pulmonary artery occlusion pressures.</span></span></p></div>","PeriodicalId":82686,"journal":{"name":"Seminars in anesthesia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2005-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1053/j.sane.2005.07.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92036357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 5

Cricoid pressure: an alternative view 环状软骨压力:另一种观点

Seminars in anesthesia Pub Date : 2005-06-01 DOI: 10.1053/j.sane.2005.04.005

Hans-Jaochim Priebe MD (FRCA, FFARCSI)

引用次数: 14

The pharmacology of inhaled anesthetics 吸入麻醉剂的药理学

Seminars in anesthesia Pub Date : 2005-06-01 DOI: 10.1053/j.sane.2005.04.004

Edmond I. Eger II MD

{"title":"The pharmacology of inhaled anesthetics","authors":"Edmond I. Eger II MD","doi":"10.1053/j.sane.2005.04.004","DOIUrl":"10.1053/j.sane.2005.04.004","url":null,"abstract":"<div><p>The two most popular potent inhaled anesthetics, desflurane and sevoflurane, differ in pharmacological advantages and disadvantages in sometimes subtle and sometimes obvious ways. Sevoflurane has a low solubility and absent pungency that makes it easy to use and is the anesthetic of choice for an inhalational induction of anesthesia. It does not stimulate the circulation. In contrast, concentrations exceeding 6% desflurane can cause airway irritation and circulatory stimulation, especially early in anesthesia. Desflurane requires a greater educational investment to deal with these issues. The lower solubility of desflurane (half that of sevoflurane) allows a faster recovery, often an earlier time to PACU discharge, and an earlier restoration of adequate ventilation and control of protective pharyngeal reflexes. Desflurane’s resistance to degradation by normal absorbents allows its use at low inflow rates (eg, 500 mL/min), whereas sevoflurane must be used at inflow rates of 1 L/min or more (2 L/min after 2 MAC-hours). Higher inflow rates increase cost. Desiccated absorbent degradation of sevoflurane (but not desflurane) can result in high temperatures and fires. Desiccated absorbents degrade both anesthetics to carbon monoxide, more with desflurane. Sevoflurane, but not desflurane, can cause convulsions. Desflurane and sevoflurane share several desirable attributes. Both may be used with laryngeal mask airways with minimal evidence of airway irritation during maintenance of anesthesia in either smokers or nonsmokers. Organ toxicity is unremarkable. Both may protect vital organs by “anesthetic preconditioning” (APC). In animals, APC with desflurane may provide greater myocardial protection against hypoxia, but in humans, desflurane and sevoflurane appear to be equally protective. Because both are halogenated solely with fluorine, neither materially affects the ozone layer.</p></div>","PeriodicalId":82686,"journal":{"name":"Seminars in anesthesia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2005-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1053/j.sane.2005.04.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114068766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 44

Intravenous (non-opioid) anesthesia 静脉(非阿片类药物)麻醉

Seminars in anesthesia Pub Date : 2005-06-01 DOI: 10.1053/j.sane.2005.04.002

Paul F. White PhD, MD (FANZCA)

引用次数: 12

Preoperative evaluation 术前评估

Seminars in anesthesia Pub Date : 2005-06-01 DOI: 10.1053/j.sane.2005.04.003

Elizabeth A.M. Frost MD

引用次数: 0

The future of anesthesia practice: hedge your practice’s chances of being on, not under, the leading edge of the wave 麻醉实践的未来:对冲你的实践在浪潮前沿的机会，而不是在浪潮前沿之下

Seminars in anesthesia Pub Date : 2005-06-01 DOI: 10.1053/j.sane.2005.04.006

Mark F. Weiss JD