Apneic Oxygenation Versus Low-Tidal-Volume Ventilation in Anesthetized Cardiac Surgical Patients: A Prospective, Single-Center, Randomized Controlled Trial

Machan, Laura; Чурилов, Леонид; Hu, Raymond; Peyton, Philip J; Tan, Chong Oon; Pillai, Parameswan; Ellard, Louise; Harley, Ian; Story, David A; Matalanis, George; Roubos, Nicholas; Seevanayagam, Sivendran; Weinberg, Laurence

doi:10.1053/j.jvca.2016.12.019

Cited by 5 publications

(4 citation statements)

References 9 publications

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“…We performed a post-hoc analysis utilising data from a previously published randomised controlled trial[5]. In the original single centre, randomised controlled study, adult patients over the age of 18 years, undergoing elective CABG requiring harvesting of the left internal mammary artery were included.…”

Section: Methodsmentioning

confidence: 99%

Relationship between acute hypercarbia and hyperkalaemia during surgery

Weinberg¹,

Russell²,

Mackley³

et al. 2019

WJCC

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BACKGROUNDThe relationship between hyperkalaemia and metabolic acidosis is well described in the critical care setting; however, the relationship between acute respiratory acidosis and plasma potassium concentration is less well understood. In a controlled model of increasing levels of hypercarbia, we tested the hypothesis of whether increasing levels of hypercarbia are associated with changes in plasma potassium concentrations.AIMTo determine whether increasing levels of hypercarbia are associated with changes in plasma potassium concentrations.METHODSWe performed a post-hoc study examining changes in serum potassium in 24 patients who received increased levels of hypercarbia during cardiac surgery. Arterial blood gases and plasma concentrations of potassium were measured at baseline, 3 min prior to, and then every 3 min for 15 min during the intervention of hypercarbia. The primary endpoint was the absolute change in serum K+ at 15 min compared to the baseline K+ value. The following secondary endpoints were evaluated: (1) The association between CO2 and serum K+ concentration; and (2) The correlation between plasma pH and serum K+ concentrations.RESULTSDuring the intervention, PaCO2 increased from 43.6 mmHg (95%CI: 40.1 to 47.1) at pre-intervention to 83.9 mmHg (95%CI: 78.0 to 89.8) at 15 min after intervention; P < 0.0001. The mean (SD) serum potassium increased from 4.16 (0.35) mmol/L at baseline to 4.28 (0.33) mmol/L at 15 min (effect size 0.09 mol/L; P = 0.22). There was no significant correlation between PaCO2 and potassium (Pearson’s coefficient 0.06; 95%CI: -0.09 to 0.21) or between pH and potassium (Pearson’s coefficient -0.07; 95%CI: -0.22 to 0.09).CONCLUSIONAcute hypercarbia and subsequent respiratory acidaemia were not associated with hyperkalaemia in patients undergoing major surgery.

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Section: Methodsmentioning

confidence: 99%

Relationship between acute hypercarbia and hyperkalaemia during surgery

Weinberg¹,

Russell²,

Mackley³

et al. 2019

WJCC

Self Cite

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“…Oxygen insufflation via a tracheal tube or endobronchial catheter has been used instead of conventional mechanical ventilation to improve surgical access during internal mammary artery harvest for coronary artery bypass grafting .…”

Section: Apnoeic Oxygenation For the Avoidance Of Lung Movementmentioning

confidence: 99%

Uses and mechanisms of apnoeic oxygenation: a narrative review

Lyons

Callaghan

2019

Anaesthesia

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Apnoeic oxygenation refers to oxygenation in the absence of spontaneous respiration or mechanical ventilation. It has been described in humans for over half a century and has seen a resurgence in interest given its potential to delay oxygen desaturation during airway management, especially with the advent of high-flow nasal cannulae. This narrative review summarises our current understanding of the mechanisms of gas exchange during apnoeic oxygenation and its diverse range of clinical applications, including its use at induction of anaesthesia and for the facilitation of 'tubeless anaesthesia'. Additional discussion covers use in critical care, obese, obstetric and paediatric sub-populations. The article also highlights current research efforts aiming to enhance the evidence base for the use of this technique.

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“…To achieve this objective, we pursued a well-established and safe intraoperative technique called “adequate preoxygenation with apneic oxygenation.” This method uses the anesthesia machine to control respiratory movements during procedures that require higher precision [e.g., radiation therapy in breast cancer treatment ( 63 ) and coronary artery bypass grafting ( 64 , 65 )]. In this technique, anesthesiologists start by preoxygenating (denitrogenating) the patient to 100% oxygen (O 2 ) for a few minutes before switching off the mechanical ventilator and inducing a long and safe apnea phase (i.e., periods with no breathing and RIM in intubated patients).…”

Section: Resultsmentioning

confidence: 99%

Fiberbots: Robotic fibers for high-precision minimally invasive surgery

Abdelaziz,

Zhao,

Gil Rosa

et al. 2024

Sci. Adv.

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Precise manipulation of flexible surgical tools is crucial in minimally invasive surgical procedures, necessitating a miniature and flexible robotic probe that can precisely direct the surgical instruments. In this work, we developed a polymer-based robotic fiber with a thermal actuation mechanism by local heating along the sides of a single fiber. The fiber robot was fabricated by highly scalable fiber drawing technology using common low-cost materials. This low-profile (below 2 millimeters in diameter) robotic fiber exhibits remarkable motion precision (below 50 micrometers) and repeatability. We developed control algorithms coupling the robot with endoscopic instruments, demonstrating high-resolution in situ molecular and morphological tissue mapping. We assess its practicality and safety during in vivo laparoscopic surgery on a porcine model. High-precision motion of the fiber robot delivered endoscopically facilitates the effective use of cellular-level intraoperative tissue identification and ablation technologies, potentially enabling precise removal of cancer in challenging surgical sites.

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Apneic Oxygenation Versus Low-Tidal-Volume Ventilation in Anesthetized Cardiac Surgical Patients: A Prospective, Single-Center, Randomized Controlled Trial

Cited by 5 publications

References 9 publications

Relationship between acute hypercarbia and hyperkalaemia during surgery

Relationship between acute hypercarbia and hyperkalaemia during surgery

Uses and mechanisms of apnoeic oxygenation: a narrative review

Fiberbots: Robotic fibers for high-precision minimally invasive surgery

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