Browsing by Author "Gadhinglajkar, Shrinivas Vitthal"

Now showing 1 - 4 of 4
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    CASE 1-2009 Retrocardiac Sponge-Induced Hemodynamic Instability After Cardiac Surgery
    (JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA, 2009)
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    OXYGRAPHY: AN UNEXPLORED PERIOPERATIVE MONITORING MODALITY
    (JOURNAL OF CLINICAL MONITORING AND COMPUTING, 2009)
    Capnography waveforms and capnometry are useful perioperative monitoring tools. The paramagnetic oxygen analyzers incorporated in many clinical monitoring systems estimate oxygen concentration in the breathing circuit during various phases of ventilation. The oxygen concentration is plotted as a real-time waveform and displayed as an oxygraph. However, the clinical utility of oxygraphy is under evaluated. We are reporting four different clinical scenarios in neurosurgical patients, wherein the information yielded by oxygraphy were either not available on the capnograph or were revealed in a more promising way on the oxygraph than on the capnograph. A real-time oxygraphy waveform has four phases similar to a capnograph, although displayed in a reverse manner. Oxygraphy was useful in our patient to determine the adequacy of preoxygenation. Airway complications and unwanted neuromuscular recovery can be detected earlier by oxygraphy compared to capnography. The oxygraphy peak-to-baseline scale difference can be compressed to as low as to 6% of oxygen concentration. When the peak-to-baseline scale difference is 6 mmHg, the oxygraph becomes sensitive to even minute changes in respiratory flow characteristics. Oxygraphy may have a potential role in clinical monitoring.
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    Retrograde cerebral perfusion for treatment of air embolism after valve surgery.
    (Asian cardiovascular & thoracic annals, 2004)
    Air embolism occurred after termination of cardiopulmonary bypass in a 22-year-old man undergoing aortic valve replacement for rheumatic aortic insufficiency. Normothermic retrograde cerebral perfusion was instituted for 5 min at a flow rate of 300-500 mL.min(-1), maintaining internal jugular vein pressure < 25 mmHg. The aortic cannula was declamped intermittently for 5-10 seconds. Mean arterial pressure was kept at 60-70 mmHg. The patient recovered without any neurological deficit.