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  • Online Resource  (8)
  • Imanaka, Hideaki  (8)
  • 1
    Online Resource
    Online Resource
    Autotriggering caused by cardiogenic oscillation during flow-triggered mechanical ventilation
    Ovid Technologies (Wolters Kluwer Health) ; 2000
    In:  Critical Care Medicine Vol. 28, No. 2 ( 2000-02), p. 402-407
    Details
    In: Critical Care Medicine, Ovid Technologies (Wolters Kluwer Health), Vol. 28, No. 2 ( 2000-02), p. 402-407
    Type of Medium: Online Resource
    ISSN: 0090-3493
    URL: Article
    DOI: 10.1097/00003246-200002000-00019
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2000
    detail.hit.zdb_id: 2034247-0
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  • 2
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    Detection of Tracheal Stenosis by Cineangiocardiography in Infants with Congenital Heart Disease
    Ovid Technologies (Wolters Kluwer Health) ; 1997
    In:  Anesthesia & Analgesia Vol. 85, No. 5 ( 1997-11), p. 1180-1181
    Details
    In: Anesthesia & Analgesia, Ovid Technologies (Wolters Kluwer Health), Vol. 85, No. 5 ( 1997-11), p. 1180-1181
    Type of Medium: Online Resource
    ISSN: 0003-2999
    URL: Article
    DOI: 10.1097/00000539-199711000-00052
    RVK:
    XA 22250
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 1997
    detail.hit.zdb_id: 2018275-2
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  • 3
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    Effect of Patient-triggered Ventilation on Respiratory Workload in Infants after Cardiac Surgery
    Ovid Technologies (Wolters Kluwer Health) ; 2000
    In:  Anesthesiology Vol. 93, No. 5 ( 2000-11-01), p. 1238-1244
    Details
    In: Anesthesiology, Ovid Technologies (Wolters Kluwer Health), Vol. 93, No. 5 ( 2000-11-01), p. 1238-1244
    Abstract: Patient-triggered ventilation (PTV) is commonly used in adults to avoid dyssynchrony between patient and ventilator. However, few investigations have examined the effects of PTV in infants. Our objective was to determine if pressure-control PTV reduces infants' respiratory workloads in proportion to the level of pressure control. We also explored which level of pressure control provided respiratory workloads similar to those after the extubation of the trachea. Methods When seven post-cardiac surgery infants, aged 1 to 11 months, were to be weaned with the pressure-control PTV, we randomly applied five levels of pressure control: 0, 4, 8, 12, and 16 cm H2O. All patients were ventilated with assist-control mode, triggering sensitivity of 1 l/min, and positive end-expiratory pressure of 3 cm H2O. After establishing steady state conditions at each level of pressure control, arterial blood gases were analyzed and esophageal pressure (Pes), airway pressure, and airflow were measured. Inspiratory work of breathing (WOB) was calculated using a Campbell diagram. A modified pressure-time product (PTPmod) and the negative deflection of Pes were calculated from the Pes tracing below the baseline. The measurement was repeated after extubation. Results Pressure-control PTV supported every spontaneous breath. By decreasing the level of pressure control, respiratory rate increased, tidal volume decreased, and as a result, minute ventilation and arterial carbon dioxide partial pressure were maintained stable. The WOB, PTPmod, and negative deflection of Pes increased as pressure control level was decreased. The WOB and PTPmod at 4 cm H2O pressure control and 0 cm H2O pressure control and after extubation were significantly greater than those at the pressure control of 16, 12, and 8 cm H2O (P & lt; 0.05). The WOB and PTPmod were almost equivalent after extubation and at 4 cm H2O pressure control. Conclusions Work of breathing and PTPmod were changed according to the pressure control level in post-cardiac surgery infants. PTV may be feasible in infants as well as in adults.
    Type of Medium: Online Resource
    ISSN: 0003-3022
    URL: Article
    DOI: 10.1097/00000542-200011000-00017
    RVK:
    XA 22600
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2000
    detail.hit.zdb_id: 2016092-6
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  • 4
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    Effect of Ventilatory Settings on Accuracy of Cardiac Output Measurement Using Partial CO2Rebreathing
    Ovid Technologies (Wolters Kluwer Health) ; 2002
    In:  Anesthesiology Vol. 96, No. 1 ( 2002-01-01), p. 96-102
    Details
    In: Anesthesiology, Ovid Technologies (Wolters Kluwer Health), Vol. 96, No. 1 ( 2002-01-01), p. 96-102
    Abstract: Recently, a new device has been developed to measure cardiac output noninvasively using partial carbon dioxide (CO(2)) rebreathing. Because this technique uses CO(2) rebreathing, the authors suspected that ventilatory settings, such as tidal volume and ventilatory mode, would affect its accuracy: they conducted this study to investigate which parameters affect the accuracy of the measurement. Methods The authors enrolled 25 pharmacologically paralyzed adult post-cardiac surgery patients. They applied six ventilatory settings in random order: (1) volume-controlled ventilation with inspired tidal volume (V(T)) of 12 ml/kg; (2) volume-controlled ventilation with V(T) of 6 ml/kg; (3) pressure-controlled ventilation with V(T) of 12 ml/kg; (4) pressure-controlled ventilation with V(T) of 6 ml/kg; (5) inspired oxygen fraction of 1.0; and (6) high positive end-expiratory pressure. Then, they changed the maximum or minimum length of rebreathing loop with V(T) set at 12 ml/kg. After establishing steady-state conditions (15 min), they measured cardiac output using CO(2) rebreathing and thermodilution via a pulmonary artery catheter. Finally, they repeated the measurements during pressure support ventilation, when the patients had restored spontaneous breathing. The correlation between two methods was evaluated with linear regression and Bland-Altman analysis. Results When VT was set at 12 ml/kg, cardiac output with the CO(2) rebreathing technique correlated moderately with that measured by thermodilution (y = 1.02x, R = 0.63; bias, 0.28 l/min; limits of agreement, -1.78 to +2.34 l/min), regardless of ventilatory mode, oxygen concentration, or positive end-expiratory pressure. However, at a lower VT of 6 ml/kg, the CO(2) rebreathing technique underestimated cardiac out-put compared with thermodilution (y = 0.70x; R = 0.70; bias, -1.66 l/min; limits of agreement, -3.90 to +0.58 l/min). When the loop was fully retracted, the CO(2) rebreathing technique overestimated cardiac output. Conclusions Although cardiac output was underreported at small VT values, cardiac output measured by the CO(2) rebreathing technique correlates fairly with that measured by the thermodilution method.
    Type of Medium: Online Resource
    ISSN: 0003-3022
    URL: Article
    DOI: 10.1097/00000542-200201000-00021
    RVK:
    XA 22600
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2002
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  • 5
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    Effects of Nitric Oxide Inhalation After Pulmonary Thromboendarterectomy for Chronic Pulmonary Thromboembolism
    Elsevier BV ; 2000
    In:  Chest Vol. 118, No. 1 ( 2000-07), p. 39-46
    Details
    In: Chest, Elsevier BV, Vol. 118, No. 1 ( 2000-07), p. 39-46
    Type of Medium: Online Resource
    ISSN: 0012-3692
    URL: Article
    DOI: 10.1378/chest.118.1.39
    RVK:
    XA 36340
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2000
    detail.hit.zdb_id: 2007244-2
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  • 6
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    Nitric Oxide Inhalation as a Chemical Assist for Circulation in Patients After Cardiovascular Surgery
    Wiley ; 1999
    In:  Artificial Organs Vol. 23, No. 2 ( 1999-02), p. 169-174
    Details
    In: Artificial Organs, Wiley, Vol. 23, No. 2 ( 1999-02), p. 169-174
    Abstract: The objective of this study was to investigate whether nitric oxide (NO) inhalation might be an alternative strategy as a chemical assist for the circulation in patients showing a deterioration in oxygen delivery. Twelve adult patients whose oxygen delivery indices (D O 2 I) were less than 400 ml/min/m 2 after cardiovascular surgery were included in this study. NO was administered via a premixing system or a side stream system at doses between 1 and 10 (5.1 ± 2.4) ppm. Data obtained before and during a 120 min NO inhalation were compared using the paired Student's t ‐test. The increase in Pa O 2 /Fi O 2 resulting from NO inhalation was significant (from 162 to 251 mm Hg). D O 2 I increased significantly from 326 to 417 ml/min/m 2 concomitantly with significant increases in both arterial oxygen content (Ca O 2 ) and cardiac index (CI) (from 14.1 to 15.4 vol% and from 2.31 to 2.71 L/min/m 2 , respectively). The increase in S VO 2 during NO inhalation was significant (from 55.2 to 62.6%). Among the other hemodynamic parameters, both total pulmonary resistance and systolic pulmonary arterial pressure (SPAP) showed significant decreases during NO inhalation, but right atrial pressure did not change significantly. There was a close relationship between the baseline SPAP level (bSPAP) and the decrease in SPAP during NO inhalation (dSPAP) (r = −0.88). However, negative correlations were observed between bSPAP and percentage increase in CI (%CI) (r = −0.61) and between bSPAP and percentage increase in D O 2 I (% D O 2 I) (r = −0.48). Moreover, positive relationships were observed between dSPAP and %CI (r = 0.62) and between dSPAP and %D O 2 I (r = 0.45). Hemoglobin (Hb) increased significantly from 11.0 to 11.4 g/dl. There were no significant changes in Fi O 2 , pH, Pa CO 2 , or base excess (BE) during NO inhalation. The level of methemoglobin measured during the study period remained within the normal range (0.86 ± 0.23%). In conclusion, NO inhalation could be an efficient and alternative assist for the circulation in patients whose oxygen delivery deteriorates after cardiovascular surgery.
    Type of Medium: Online Resource
    ISSN: 0160-564X , 1525-1594
    URL: Article
    DOI: 10.1046/j.1525-1594.1999.06215.x
    Language: English
    Publisher: Wiley
    Publication Date: 1999
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  • 7
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    Online Resource
    Cardiac Surgery and Inhaled Nitric Oxide: Indication and Follow‐up (2–4 Years)
    Wiley ; 1998
    In:  Artificial Organs Vol. 22, No. 10 ( 1998-10), p. 886-891
    Details
    In: Artificial Organs, Wiley, Vol. 22, No. 10 ( 1998-10), p. 886-891
    Abstract: We studied the effect of inhaled nitric oxide (NO) on 80 patients who had undergone cardiac surgery in our center. The indications for receiving NO inhalation and the number of patients were as follows: Pp/Ps 〉 0.5 for pulmonary hypertension (PH) (n = 32; 21 children and 11 adults), severe PH crisis (n = 9), high pulmonary vascular tone (Glenn pressure more than 18 mm Hg after bidirectional Glenn operation) or arterial oxygen saturation (Sa O 2 ) less than 70% despite an Fi O 2 of 1.0 after Blalock‐Taussig shunt (n = 6), mean pulmonary artery pressure (PAP) 〉 15 mm Hg and transpulmonary gradient (TPG) (mean PAP − left atrial pressure [LAP]) 〉 8 mm Hg after Fontan‐type operation (n = 18), elevated pulmonary vascular tone (mean PAP 〉 30 mm Hg and left ventricular assist system [LVAS] flow rate 〈 2.5 L/min/m 2 ) in patients with LVAS (n = 3), and impaired oxygenation (Pa O 2 /Fi O 2 〈 100 under positive end‐expiratory pressure [PEEP] 〉 5 cm H 2 O) (n = 12). Low dose inhaled NO (10 ppm) had the following effects. In adult PH patients, it significantly reduced the mean PAP (from 37.3 to 27.0 mm Hg; average values are given) and increased the mean systemic arterial pressure (SAP) (64.7 to 75.3 mm Hg). In infant PH patients, it increased the mean SAP (51.8 to 56.1 mm Hg). In patients with a PH crisis, it significantly reduced the central venous pressure (CVP) (13.3 to 8.8 mm Hg) while increasing both the mean SAP (49.4 to 57.9 mm Hg) and Pa O 2 /Fi O 2 (135 to 206). In patients after a Fontan‐type operation, it significantly reduced the mean PAP (16.8 to 13.8 mm Hg) and TPG (9.5 to 5.8 mm Hg). In patients under LVAS, it reduced the CVP (11.7 to 8.0 mm Hg) and mean PAP (32.0 to 24.7 mm Hg). In impaired oxygenation patients, Pa O 2 /Fi O 2 was increased (75 to 106). Sixty‐five patients were all followed for 2.0–4.3 years (average, 3.1 years). All 65 patients remained free from oxygen requirement, and possible chronic adverse effects including the occurrence of malignant tumors or chronic inflammation in the respiratory tract were not observed.
    Type of Medium: Online Resource
    ISSN: 0160-564X , 1525-1594
    URL: Article
    DOI: 10.1046/j.1525-1594.1998.06186.x
    Language: English
    Publisher: Wiley
    Publication Date: 1998
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  • 8
    Online Resource
    Online Resource
    Detection of Tracheal Stenosis by Cineangiocardiography in Infants with Congenital Heart Disease
    Ovid Technologies (Wolters Kluwer Health) ; 1997
    In:  Anesthesia & Analgesia Vol. 85, No. 5 ( 1997-11), p. 1180-1181
    Details
    In: Anesthesia & Analgesia, Ovid Technologies (Wolters Kluwer Health), Vol. 85, No. 5 ( 1997-11), p. 1180-1181
    Type of Medium: Online Resource
    ISSN: 0003-2999
    URL: Article
    DOI: 10.1213/00000539-199711000-00052
    RVK:
    XA 22250
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 1997
    detail.hit.zdb_id: 2018275-2
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