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Since the introduction of transesophageal echocar-diography (TEE) to the operating room in the early 1980s, 1-4 its effectiveness as a clinical monitor to assist in the hemodynamic management of patients during general anesthesia and its reliability to make intraoperative diagnoses during cardiac operations has been well established. 5-26 In recognition of(More)
Sixteen consenting patients scheduled for elective thoracotomy were enrolled into a randomized trial of epidural morphine and hydromorphone. Each patient had a lumbar epidural catheter placed preoperatively for the purpose of post-thoracotomy analgesia. Shortly before the end of the operative procedure each patient received 5 mg of morphine and 0.75 mg of(More)
T here are no objective criteria for selecting the size of a double-lumen endobronchial tube (DLT) (1). An inappropriately sized DLT can cause airway trauma and interfere with oxygenation and lung separation during one-lung ventilation. The goal of this study was to determine if measurement of tracheal diameter from the preoperative chest radiograph can be(More)
OBJECTIVE Pulse contour analysis can be used to provide beat-to-beat cardiac output (CO) measurement. The current study sought to evaluate this technique by comparing its results with lithium dilution CO (LiCO) measurements. DESIGN Prospective, observational study. SETTING Surgical intensive care unit. PATIENTS Twenty-two patients after cardiac or(More)
Pressure monitoring systems influence the contour of the displayed wave-forms and, on occasion, can introduce significant artifact in the pressure traces. It is important to understand the technical details of invasive pressure monitoring to interpret better the information presented. Careful observation of the arterial pressure waveform can provide(More)
Esophageal Doppler ultrasonography offers a continuous and noninvasive alternative to standard thermodilution cardiac output monitoring. A total of 372 simultaneous measurements of Doppler and thermodilution cardiac output were compared in 16 patients undergoing cardiac surgery. In addition, echocardiographic aortic diameter measurement, necessary for(More)
It can be difficult to localize or even lateralize the site of persistent bronchopleural fistula in patients who have undergone thoracotomy. If the site of persistent air leak can be identified noninvasively, it may be possible to repair the leak with thoracoscopic techniques and thereby avoid repeat thoracotomy. This article reports experience using(More)
Breakdown of the closure of the main-stem bronchus after pneumonectomy is a dreaded complication, and empyema and bronchopleural fistula frequently develop in patients who survive. Management of these fistulas remains a formidable therapeutic challenge, which has been approached with a variety of surgical techniques. We report our experience with anterior(More)
The recurrence of a benign mediastinal bronchogenic cyst 20 years after partial excision precipitated potentially serious vascular and pulmonary complications. Aggressive total surgical excision should be feasible in the majority of cases. An approach via a median sternotomy offers distinct advantages in certain cases and should be considered. Computerized(More)