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2001, Número 1

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Med Crit 2001; 15 (1)


Vigilancia del consumo de oxígeno durante la anestesia total endovenosa y la anestesia balanceada

Fernández DPL, Rodríguez MV, Ortega J, Álvarez GR, Horta BE, Genovés GH, Zambada ZC

Idioma: Español
Referencias bibliográficas: 46
Paginas: 5-10
Archivo PDF: 76.92 Kb.


RESUMEN

Objetivo: Describir los cambios del consumo de oxígeno medido por medios no invasivos durante la anestesia intravenosa y balanceada. Diseño: Reporte de casos. Lugar: Departamentos de Anestesiología y Fisiología Pulmonar de un hospital privado de tercer nivel de la Ciudad de México. Pacientes: Cuarenta y dos pacientes ASA I-II sometidos a laparotomía electiva. Intervenciones: Veintidós pacientes recibieron propofol y fentanil en infusión continua (grupo I) y 22 pacientes fueron manejados con sevoflurano más fentanil y cisatracurio en infusión continua (grupo II). Se midió el consumo de oxígeno con un monitor Datex-Ohmeda ASS/3 seis veces en ambos grupos. Mediciones y resultados principales: Se encontró que el VO2 fue a la intubación (112 ± 103 vs 145 ± 126.4 mL/min), al principio de la cirugía (89 ± 39.5 vs 95 ± 74.8 mL/min) y durante la cirugía (110 ± 157.3, 100.5 ± 21.7. 95.2 ± 48.2 y 110 ± 40.2 vs 100 ± 145.6, 130 ± 135.3, 140 ± 132.8 y 113 ± 80.2 mL/min), respectivamente para los grupos I y II (p ‹ 0.01). Conclusión: Los pacientes manejados con anestesia balanceada pueden tener descenso del VO2.


REFERENCIAS (EN ESTE ARTÍCULO)

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  2. Brenner C, Ahdout J, Finegan R. Transporte de oxígeno hacia los tejidos: Desde el pulmón hacia la mitocondria. En: Cuidados intensivos. Temas actuales 1/1991 ed. Interamericana McGraw-Hill Health Care Group. 19-33.

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  4. Lind L. Metabolic gas exchange during different surgical procedures. Anaesthesia 1995; 50: 304-307.

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  6. Svensson KL, Henriksson BA, Sonander HG, Stenqvist O. Metabolic gas exchange during aortocoronary bypass surgery using a double pump system and mechanical ventilation. Acta Anaesthesiol Scand 1991; 35: 185-189.

  7. Svensson KL, Sonander HG, Stenqvist O. Validation of a system for measurement of metabolic gas exchange during anaesthesia with controlled ventilation in an oxygen consuming lung model. British Journal of Anaesthesia 1990; 64: 311-319.

  8. Noe FE, Whitty AJ, Davies KR, Wickham BL. Noninvasive Measurement of Pulmonary Gas Exchange during General Anesthesia. Anesthesia and Analgesia 1980; 59(4): 263-269.

  9. Nunn JF. Applied respiratory physiology, 3rd ed. Butterworths, London, 1987.

  10. Viale JP, Annat G, Bertrand O, Thouverez B, Hoen JP, Motin J. Continuous measurement of pulmonary gas exchange during general anaesthesia in man. Acta Anaesthesiol Scand 1988; 32: 691-697.

  11. Stoelting RK. Attenuation of blood pressure response to laryngoscopy and intubation with sodium nitroprusside. Anesth Analg 1979; 58: 116-9.

  12. Prys-Roberts C, Greene LT. Studies of anaesthesiain relation to hypertension. Haemodynamic consequences of induction and endotracheal intubation. Br J Anaesth 1971; 43: 531-47.

  13. Kanwal JS. The stress response to surgical trauma: from physiological basis to therapeutic implications. Progress in Food and Nutrition Science 1986; 10: 67-132.

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  16. Fassoulaki A, Kanaris P. Does atropine premedication affect the cardiovascular response to laryngoscopy and intubation? Br J Anesth 1982; 54: 1065-9.

  17. Fassoulaki et al. Metabolic Responses -(VO2,VCO2 and energy expenditure)-Associated with nasal intubation of the trachea. Anesth Analg 1989; 68: 112-15.

  18. Barash PG, Cullen BF, Stoelting RK [eds]; Clinical Anesthesia, Philadelphia, JB Lippincott 1999: 1021-1057.

  19. ATLS: Manual del curso Avanzado de apoyo vital en trauma. Colegio Americano de Cirujanos. 1994; 5(1era ed): 55.

  20. Henderson AM, Mosse CA, Forrester PC, Halsall D, Amstrong RF. A system for the continuous measurement of oxygen uptake and carbon dioxide output in artificially ventilated patients. British Journal of Anaesthesia 1983; 55: 701.

  21. Hedenstierna G. Gas exchange during anaesthesia. British Journal of Anaesthesia 1990; 64: 507-514.

  22. Lindahl SGE, Hulse MG, Hatch DJ. Ventilation and gas exchange during anaesthesia and surgery in spontaneously breathing infants and children. British Journal of Anaesthesia 1984; 56: 121.

  23. Torres GE. Insuficiencia respiratoria Cap. 2da. Ed. 1991; 1: 1-10, 1-19

  24. Dejours P. Oxygen demand and gas exchange. In: Wood SC, Lefant C eds. Evolution of Respiratory Processes Lung Biology in Health and Disease, New York: Marcel Dekker, 1979; 13: 1-44.

  25. Brenner C, Ahdout J, Finegan R. Transporte de oxígeno hacia los tejidos: Desde el pulmón hacia la mitocondria. En: Cuidados intensivos. Temas actuales 1/1991 ed. Interamericana McGraw-Hill Health Care Group. 19-33.

  26. Cone JB. Vigilancia del oxígeno tisular, en Cuidados intensivos. Temas actuales 1/1991 ed. Interamericana McGraw-Hill. Health Care Group 35-41.

  27. Lind L. Metabolic gas exchange during different surgical procedures. Anaesthesia 1995; 50: 304-307.

  28. Lind L. Metabolic gas exchange during gynaecological laparotomy and laparoscopy. Can J Anaesth 1994; 41(1): 19-22.

  29. Svensson KL, Henriksson BA, Sonander HG, Stenqvist O. Metabolic gas exchange during aortocoronary bypass surgery using a double pump system and mechanical ventilation. Acta Anaesthesiol Scand 1991; 35: 185-189.

  30. Svensson KL, Sonander HG, Stenqvist O. Validation of a system for measurement of metabolic gas exchange during anaesthesia with controlled ventilation in an oxygen consuming lung model. British Journal of Anaesthesia 1990; 64: 311-319.

  31. Noe FE, Whitty AJ, Davies KR, Wickham BL. Noninvasive Measurement of Pulmonary Gas Exchange during General Anesthesia. Anesthesia and Analgesia 1980; 59(4): 263-269.

  32. Nunn JF. Applied respiratory physiology, 3rd ed. Butterworths, London, 1987.

  33. Viale JP, Annat G, Bertrand O, Thouverez B, Hoen JP, Motin J. Continuous measurement of pulmonary gas exchange during general anaesthesia in man. Acta Anaesthesiol Scand 1988; 32: 691-697.

  34. Stoelting RK. Attenuation of blood pressure response to laryngoscopy and intubation with sodium nitroprusside. Anesth Analg 1979; 58: 116-9.

  35. Prys-Roberts C, Greene LT. Studies of anaesthesiain relation to hypertension. Haemodynamic consequences of induction and endotracheal intubation. Br J Anaesth 1971; 43: 531-47.

  36. Kanwal JS. The stress response to surgical trauma: from physiological basis to therapeutic implications. Progress in Food and Nutrition Science 1986; 10: 67-132.

  37. Ducey JB. Vigilancia del Oxígeno durante la anestesia. En: Cuidados intensivos. Temas actuales 1/1991 ed. Interamericana McGraw-Hl11. Health Care Group. 97-106.

  38. Fassoulaki A, Kaniaris P. Intranasal administration of nitroglycerin attenuates the pressure response to laryngoscopy and intubation of the trachea. Br J Anaesth 1983: 52.

  39. Fassoulaki A, Kanaris P. Does atropine premedication affect the cardiovascular response to laryngoscopy and intubation? Br J Anesth 1982; 54: 1065-9.

  40. Fassoulaki et al. Metabolic Responses -(VO2,VCO2 and energy expenditure)-Associated with nasal intubation of the trachea. Anesth Analg 1989; 68: 112-15.

  41. Barash PG, Cullen BF, Stoelting RK [eds]; Clinical Anesthesia, Philadelphia, JB Lippincott 1999: 1021-1057.

  42. ATLS: Manual del curso Avanzado de apoyo vital en trauma. Colegio Americano de Cirujanos. 1994; 5(1era ed): 55.

  43. Henderson AM, Mosse CA, Forrester PC, Halsall D, Amstrong RF. A system for the continuous measurement of oxygen uptake and carbon dioxide output in artificially ventilated patients. British Journal of Anaesthesia 1983; 55: 701.

  44. Hedenstierna G. Gas exchange during anaesthesia. British Journal of Anaesthesia 1990; 64: 507-514.

  45. Lindahl SGE, Hulse MG, Hatch DJ. Ventilation and gas exchange during anaesthesia and surgery in spontaneously breathing infants and children. British Journal of Anaesthesia 1984; 56: 121.

  46. Torres GE. Insuficiencia respiratoria Cap. 2da. Ed. 1991; 1: 1-10, 1-19




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