The incidence of VAE in patients undergoing TLH was 100%. VAE grade in TLH was higher compared to that in TAH, especially during transection of the round ligament and dissection of the broad ligament. Although the hemodynamic instability associated with VAE during TLH was not observed in this study, anesthesiologists must be vigilant for detection of VAE during TLH.

Venous air embolism (VAE) is the entrapment of air or medical gases into the venous system causing symptoms and signs of pulmonary vessel obstruction. The incidence of VAE during cesarean delivery ranges from 10 to 97% depending on surgical position or diagnostic tools, with a potential for life-threatening events. We reviewed extensive literatures regarding VAE in detail and herein described VAE during surgery including cesarean delivery from background and history to treatment and prevention. It is intended that present work will improve the understanding of VAE during surgery.

Mannitol could be safely used without adverse side effects in patients undergoing multivessel off-pump bypass surgery with beneficial effects in terms of preserving oxygenation, earlier extubation, and fewer patients with significant creatine kinase MB elevation.

Background:The government has attempted to control the cost of health care. However, this policy can increase the number of premature discharges from the intensive care unit (ICU), which will then increase readmission rate to the ICU. Readmission to the ICU during the same hospital stay has been identified as a quality indicator. The aim of this study was to determine the clinical features and outcome of patients readmitted to the ICU during the same hospital stay.Methods: For this study, reviewed the data from all patients admitted to the ICU between July 1, 2000 and Jun 30, 2001 were retrospectively analyzed. The data in this study included the patient demographics, hospital and ICU admission date, the diagnosis on ICU admission, co-morbid disease of the patients, Acute Physiology and Chronic Health Evaluation (APACHE) II scores on the ICU admission, the lengths of the ICU stay, the hospital days, and the patients' outcomes on hospital discharge. The reason for readmission was classified as either a recurrence of the initial disease or an occurrence of new complications, and the non-survivors and survivors after readmission to the ICU were compared.Results: The readmission rate was 7.5% and the mortality rate of the readmitted patients was 66%. The age, gender, the severity score at admission, and disease distributions were not significantly different between the readmitted patients and the non-readmitted patients. However, the lengths of the ICU stay and hospital days of the readmitted patients were significantly longer than those of the non-readmitted patients.Conclusion: Patients requiring ICU readmission during the same hospital stay had higher hospital mortality rates than the patients discharged from the ICU who did not require a subsequent readmission.

Background: Hydroxyethyl starch (HES) effectively restores plasma volume and thereby enhances microcirculation and tissue oxygenation at the expense of coagulation impairment. These effects are related to molecular weight, substitution and C2：C6 ratio. But, most of the studies regarding coagulation impairment in cardiac surgeries were performed in patients undergoing cardiopulmonary bypass which significantly causes coagulation derangements. Therefore, we have evaluated the effects of 2 different HES solutions on tissue oxygenation and postoperative bleeding in patients undergoing off-pump coronary artery bypass surgery (OPCAB). Methods: Forty four patients were prospectively enrolled. After the induction of anesthesia, either HES 130/0.4 (V group) or 200/0.5 (H group) were infused for fluid therapy to maintain predetermined urine output, cardiac index and filling pressure up to 16 h after the surgery. Tissue oxygenation profiles and respiratory parameters were recorded after induction of anesthesia, completion of distal anastomosis and sternum closure, upon admission at intensive care unit, and 4 h thereafter. The amounts of chest tube drainage, transfusion and fluid balance were measured up to 16 h after the surgery. Results: Patients' demographic data were similar between the groups. Tissue oxygenation profiles, respiratory parameters, hemodynamics, and time to extubate were not different between the groups. However, chest tube drainage and transfusion requirements were significantly less in the V group. Conclusions: In OPCAB, 6% HES 130/0.4 causes less postoperative bleeding and transfusion requirement and has a comparable efficacy on hemodynamic stability, pulmonary function and tissue oxygenation when compared to 6% HES 200/0.5.