Airway exchange catheters are semi-rigid. As such, they have the potential to damage the respiratory tract if mishandled when used for endotracheal tube exchange. Dr. Robert Axe, Department of Anaesthesia, Royql United hospital, Bath, England, and colleagues used pig trachea and lung specimens less than 48 h postmortem. These tracheas were intubated using 83 cm […]
Laparoscopic equipment, originally designed for use in adult procedures, is now widely used for pediatric and neonatal surgery. As commonly occurs in medical practice, the transition from adult to pediatric use occurs âoff-labelâ and without further investigation into the safety and efficacy of the practice. After a number of reports of catastrophic events associated with […]
Basic anesthesia care includes monitoring exhaled end-tidal carbon dioxide (ETCO2) concentration in patients undergoing sedation. The challenge is to measure end-tidal gas concentration through a cannula that is also tasked with delivering supplemental oxygen. In their article published in this monthâs issue of Anesthesia & Analgesia titled âThe Effectiveness of Oxygen Delivery and Reliability of […]
 Intrathoracic pressure changes during ventilation. Widely appreciated, but less well understood, is how changes in intrathoracic pressure change preload and cardiac output. If you ask a resident what will happen when the ventilator gives a positive pressure breath, you will likely be told that the blood pressure will drop because increased intrathoracic pressure decreases […]
Although traditional pulse oximetry is a standard monitor in anesthesia, it is limited in its ability to detect tissue hypoxia. Typical interventions used to increase SpO2 may not necessarily improve tissue oxygenation, particularly in ischemic organs. Regional oximeters measure a mix of arterial, capillary, and venous blood in brain or peripheral tissues. A new regional […]
 If you slow down the sweep speed of your monitor and examine the waveform of the pulse oximeter you will see the respiratory variation. Indeed, one could argue that this should be the default display. Particularly if a patient is paralyzed and ventilation is controlled, the variation with ventilation is related to left ventricular […]
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