Medicine and Health Sciences Commons^™

Effects Of High Intraoperative Inspired Oxygen On Postoperative Nausea And Vomiting In Gynecologic Laparoscopic Surgery, Tatjana Šimurina, Md, Msc, Boris Mraović, Md, Simon Mikulandra, Md, Msc, Zdenko Sonicki, Md, Phd, Nina Sulen, Md, Branko Dukić, Md, Tong J. Gan, M.D

Department of Anesthesiology Faculty Papers

Study objective: To assess the efficacy of intraoperative different inspired oxygen fractions (FIO2) of 0.8 and 0.5 when compared with standard FIO2 0.3 in prevention of postoperative nausea and vomiting (PONV).

Design: A prospective, controlled, randomized, double-blind study.

Setting: General hospital, postanesthesia care unit (PACU) and gynecologic floor room. Patients: 120 ASA physical status I and II women, aged 21 to 76 y, undergoing elective gynecologic laparoscopic surgery.

Interventions: Patients were randomized to receive gas mixture of 30% oxygen in air (FI O2=0.3, group G30), 50% oxygen in air (FIO2=0.5, group G50) or 80% oxygen in air (FIO2=0.8, group G80), …

Electroconvulsive Therapy For A Patient With A Penetrating Ulcer In The Aortic Arch, Andrew Ng, Md, George Hsu, Md, Zvi Grunwald, Md

Department of Anesthesiology Faculty Papers

Case: An 85 year-old male presented with major depressive disorder refractory to medical therapy. A series of eight electroconvulsive therapy (ECT) was planned. Past medical history includes a small penetrating ulcer in the aortic arch, an ascending aortic aneurysm measuring 4.3 x 4.4 cm, atrial fibrillation on anticoagulation and hypertension. Medications include metoprolol, coumadin, simvastatin, alprazolam and venlafaxine.

Intraoperative Point-Of-Care Blood Glucose Values Show Poor Agreement With Central Lab Blood Values, Eric Schwenk, Md, Richard H. Epstein, Md, Cphims, Boris Mraovic, Md

Department of Anesthesiology Faculty Papers

Introduction:

Accuracy of point-of-care (POC) glucose devices compared to central lab values in critically ill patients has come into question, particularly during intensive insulin therapy.

POC devices perform particularly poorly in the hypoglycemic range.

Typically tested under ideal conditions in the lab; intraoperative, real-life data are lacking.

Liver Transplantation In The Face Of Severe Electrolyte Abnormalities: A Discussion Of Management Techniques, Vincent Franze, Md, Rosalba Spiritoso, Md, Elia Elia, Md, Yoogoo Kang, Md

Department of Anesthesiology Faculty Papers

Introduction:

Electrolytes disorders are a common finding in patients with End stage liver disease (ESLD). Liver transplantation (OLT) is frequently associated with massive transfusion and fluid shifts in patients with renal dysfunction, and management of hyponatremla, hyperkalemia and hypervolemia are major concerns for anesthesiologists. This case describes a multimodal approach in treatment of combined severe hyponatremla, hperkalemia and hypervolemia.

Clinical Accuracy Of A Hospital Point-Of-Care Glucose Meter, Brian R. Hipszer, Phd, Jennifer B. Lessin, Rn, Kathleen O'Malley, Rn, Zvi Grunwald, Md, Jeffrey I. Joseph, D.O.

Department of Anesthesiology Faculty Papers

Summary: Glucose meter performance was evaluated against the ISO 15197 guidelines in 221 time-matched venous and capillary blood samples. Accuracy decreased when the source of the reference and meter blood samples was not the same.

Intraoperative Insulin Administration And Hypoglycemia In Diabetic Patients, Eric Schwenk, Md, Richard H. Epstein, Md, Cphims, Boris Mraovic

Department of Anesthesiology Faculty Papers

Introduction:

Although studies are conflicting as to the benefit of intensive insulin therapy (IIT) in the critically ill, there is a 6x increase in hypoglycemia incidence in patients treated with IIT.

Anesthesia masks signs and symptoms of hypoglycemia, making intraop hypoglycemia difficult to detect clinically.

We performed this retrospective, observational analysis to:

Determine the incidence of intraoperative hypoglycemia and severe hypoglycemia

Evaluate possible causes of hypoglycemia

Determine intraop monitoring and treatment practices of diabetic patients at a large academic hospital

High Inspired Co2 Capnograph Reading Due To Misplaced End Tidal Co2 Sampling Port, Andrew Ng, Md, Elia Elia, Md, Lisa Luyun, Md

Department of Anesthesiology Faculty Papers

In conclusion, if abnormal capnography is seen where the baseline inspiratory CO2 is higher than usual, inspect the circuit for rebreathing and consider examining the position of ETCO2 sampling port. We recommend confirming ETCO2 sampling port is connected immediately distal to Y-piece before starting a case for accurate CO2 measurement.

Inadvertent Respiratory Acidosis Due To Damaged Water Trap Of Capnograph By Isoflurane, Eileen R. Manabat, Md, Richard Berman, Md, Yoogoo Kang, Md

Department of Anesthesiology Faculty Papers

Introduction: A few reports have documented isoflurane leakage causing damage to the water trap in the Drager Apollo anesthesia machine. This case describes an abnormal capnograph tracing yielding falsely normal end-tidal carbon dioxide tension (EtCO2) after breakage of the water trap by isoflurane.