Journal of clinical anesthesia · 2011
Anesthesia management of totally endoscopic atrial septal defect repair with a robotic surgical system.
Клиническое исследованиеСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Wang Gang, Gao Changqing, Zhou Qi, Chen Tingting, Wang Yao, Wang Jiali, Li Jiachun
Аннотация
STUDY OBJECTIVE: To investigate anesthetic techniques for robot-assisted endoscopic atrial septal defect (ASD) repair.
DESIGN: Clinical observational study.
SETTING: Operating room of a general military hospital.
PATIENTS: 56 adult, ASA physical status 1 and 2 patients undergoing elective general anesthesia.
INTERVENTIONS: After induction of general anesthesia, a left-sided, double-lumen endotracheal tube was positioned to allow single left-lung ventilation and contralateral CO(2) pneumothorax (capnothorax). With ultrasound guidance, peripheral cardiopulmonary bypass (CPB) catheters were placed.
MEASUREMENTS AND MAIN RESULTS: All patients tolerated single left-lung ventilation before CPB; however, hypoxia (oxygen saturation < 90%) occurred in 11 (19.6%) patients post-CPB, which required treatment with continuous positive airway pressure. Fifteen (26.8%) patients had hypotension secondary to capnothorax, which was treated with transfusion and vasopressors. Aortic cross-clamp time was 43.6 ± 11.2 minutes, and CPB time was 106.7 ± 12.4 minutes. The median intensive care unit stay was 21 hours and postoperative hospital stay was 4 to 7 days.
CONCLUSIONS: The key issue for anesthetic management of robot-assisted totally endoscopic ASD repair is maintaining stable hemodynamics and oxygenation, especially during one-lung ventilation and capnothorax.
DESIGN: Clinical observational study.
SETTING: Operating room of a general military hospital.
PATIENTS: 56 adult, ASA physical status 1 and 2 patients undergoing elective general anesthesia.
INTERVENTIONS: After induction of general anesthesia, a left-sided, double-lumen endotracheal tube was positioned to allow single left-lung ventilation and contralateral CO(2) pneumothorax (capnothorax). With ultrasound guidance, peripheral cardiopulmonary bypass (CPB) catheters were placed.
MEASUREMENTS AND MAIN RESULTS: All patients tolerated single left-lung ventilation before CPB; however, hypoxia (oxygen saturation < 90%) occurred in 11 (19.6%) patients post-CPB, which required treatment with continuous positive airway pressure. Fifteen (26.8%) patients had hypotension secondary to capnothorax, which was treated with transfusion and vasopressors. Aortic cross-clamp time was 43.6 ± 11.2 minutes, and CPB time was 106.7 ± 12.4 minutes. The median intensive care unit stay was 21 hours and postoperative hospital stay was 4 to 7 days.
CONCLUSIONS: The key issue for anesthetic management of robot-assisted totally endoscopic ASD repair is maintaining stable hemodynamics and oxygenation, especially during one-lung ventilation and capnothorax.
Предметные рубрики MeSH
AdolescentAdultAgedAnesthesia, GeneralCardiopulmonary BypassEndoscopyFemaleHeart Septal Defects, AtrialHemodynamicsHospitals, MilitaryHumansHypotensionHypoxiaIntensive Care UnitsIntubation, IntratrachealLength of StayMaleMiddle AgedOxygenPneumothorax, ArtificialRespiration, ArtificialRoboticsTime FactorsUltrasonography, InterventionalYoung Adult