http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
- 中文 을 입력하시려면 zhongwen을 입력하시고 space를누르시면됩니다.
- 北京 을 입력하시려면 beijing을 입력하시고 space를 누르시면 됩니다.
RISS 인기검색어
- 검색키워드
- 주제어 : Tracheal Extubation (검색결과 3 건)
- 무료
- 기관 내 무료
- 유료
-
신경외과 수술 환자의 기관내 튜브 발관을 위한 Isoflurane의 호기말 최소 폐포 농도 측정
김시오 慶北大學校 醫科大學 1996 慶北醫大誌 Vol.37 No.1
목적 : 이 연구는 두부손상 신경외과 수술환자의 기관내 튜브발관에 의한 고혈압과 빈맥으로 뇌압상승을 초래하는 것을 방지할 목적으로, 마취가 깊게 유지된 상태에서의 기관내 튜브 발관시의 호기말 최소 폐포 농도 측정을 하기 위하여 시행하였다. 대상 및 방법 : 의식장애가 심하지 않고 계획수술로 진행된 뇌동맥류 환자 23명을 대상으로 수술이 끝난 후 미리 정해진 농도의 isoflurane을 최소한 15분간 투여후 기관내 튜브를 발관하였을때 환자가 기침, 숨 참기, 기도 폐색, 후두경련등이 있는 경우 불만족(unsatisfactory)하다고 하고 결과를 각각의 정해진 isoflurane농도에 만족과 불만족으로 표시한 후 50% 환자에서 만족하는 호기말 isoflurane의 농도를 구하였다. 결과 : 기관내 튜브 발관시 50%의 환자에서 만족하는 호기말 isoflurane의 농도는 0.90%이었고 이때의 standard error는 ±0.17이었다. 결론 : 호기말 isoflurane의 농도 0.90%에서 50%의 두부손상 신경외과 수술환자에서 기침등의 원치 않는 부작용 없이 기관내 튜브를 발관할 수 있다고 하겠다. Background : Tracheal extubation is also as important as tracheal intubation in anesthetic management. So deeply anesthetized extubation is recommended not to produce hypertension and tachycardia which is harmful in neurosurgical patients. This study was done to determine a minimum alveolar con centration of isoflurane for tracheal extubation in neurosurgical patients. Methods : Twenty-three patients with minimum neurologic deficit were undergone aneurysmal clip ping operation. At the end of surgery a predetermined end-tidal concentration was achieved, a steady state maintained for at least 15min, and the trachea was extubated. In patients who coughed or bucked on the endotracheal tube during suctioning of oropharynx, or who moved or coughed within 1 min of tracheal extubation, or who developed breath-holding or laryngospasm after tracheal extubation, extubation was considered unsatisfactory. Results were plotted as satisfactory or unsatisfactory extubation versus end-tidal isoflurane concentration. End-tidal concentration of isoflurane at which tracheal extubation was accomplished in 50% of pa tients satisfactorily was estimated by probit analysis. Results : The minimum alveolar concentrations of isoflurane at which 50% of patients has satisfactory tracheal extubation was found to be 0.90% (standard error ±0.17). Conclusions : In 50% of anesthetized neurosurgical patients tracheal extubation may be accomplished without coughing or moving at 0.90% end-tidal isoflurane concentration.
-
Intraoperative predictors of early tracheal extubation after living-donor liver transplantation
이세린,사계절,김윤아,박철수 대한마취통증의학회 2014 Korean Journal of Anesthesiology Vol.67 No.2
Background: Prolonged mechanical ventilation after liver transplantation has been associated with deleterious clinical outcomes, so early tracheal extubation posttransplant is now increasing. However, there is no universal clinical criterion for predicting early extubation in living-donor liver transplantation (LDLT). We investigated specific predictors of early extubation after LDLT. Methods: Perioperative data of adult patients undergoing LDLT were reviewed. “Early” extubation was defined as tracheal extubation in the operating room or intensive care unit (ICU) within 1 h posttransplant, and we divided patients into early extubation (EX) and non-EX groups. Potentially significant (P < 0.10) perioperative variables from univariate analyses were entered into multivariate logistic regression analyses. Individual cut-offs of the predictors were calculated by area under the receiver operating characteristic curve (AUC) analysis. Results: Of 107 patients, 66 (61.7%) were extubated early after LDLT. Patients in the EX group showed shorter stays in the hospital and ICU and lower incidences of reoperation, infection, and vascular thrombosis. Preoperatively, model for end-stage liver disease score, lung disease, hepatic encephalopathy, ascites, and intraoperatively, surgical time, transfusion of packed red blood cell (PRBC), urine output, vasopressors, and last measured serum lactate were associated with early extubation (P < 0.05). After multivariate analysis, only PRBC transfusion of ≤ 7.0 units and last serum lactate of ≤ 8.2 mmol/L were selected as predictors of early extubation after LDLT (AUC 0.865). Conclusions: Intraoperative serum lactate and blood transfusion were predictors of posttransplant early extubation. Aggressive efforts to ameliorate intraoperative circulatory issues would facilitate successful early extubation after LDLT.
-
조진덕 ( Jin Duck Cho ),박성식 ( Sung Sik Park ) 대한마취과학회 2009 Korean Journal of Anesthesiology Vol.57 No.4
Background: Endotracheal tube extubation can cause laryngospasm, aspiration, upper airway obstruction and hypoxia. In addition, the risk of pulmonary complication increases during extubation for the patients with a difficult airway or a cervical spine injury. The aim of this study was to exam the effect of continuous positive airway pressure (CPAP) on the post-extubation airway patency and the recovery from anesthesia at the recovery room. Methods: 30 adult patients who were scheduled for spine surgery were randomly allocated into 2 groups depending on the using of CPAP before extubation. Neuromuscular monitoring was performed via accelomyography. Tracheal extubation was performed at a TOF ratio of 70%. The incidence of spontaneous recovery of respiration, without airway manipulation and hypoxia, at the recovery room was measured for each group. The time to get a PAR score of 10 at the recovery room and the discharge time from the recovery room were checked too. Results: The incidence of spontaneous recovery of respiration without airway manipulation was 67% in the CPAP group, which was significantly greater than that of the control group (13%). Yet there was no difference between the CPAP and control groups for the incidence of hypoxia in the recovery room (13% and 20%, respectively). There were also no differences in the time to get a PAR score of 10 at the recovery room and the discharge time from the recovery room. Conclusions: CPAP that is applied for tracheal tube extubation improves the immediate post-extubation airway patency, but it does not reduce the recovery room pulmonary complications and the recovery room discharge time. (Korean J Anesthesiol 2009;57:450∼4)
연관 검색어 추천
이 검색어로 많이 본 자료
활용도 높은 자료
