Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0018799 (heart disease)
 34,133 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Twenty-four patients with severe, 24 with moderate, and 24 without heart disease were selected for measurements of systolic time intervals (STI) and blood pressure before and during anesthesia. In all patients anesthesia was induced with thiopental, 4 mg/kg. After tracheal intubation, 12 patients from each heart-disease class received halothane-N2O-O2 (halothane) and 12 patients from each class morphine-d-tubocurarine-N2O-O2 (MS-dTc). Thiopental increased the pre-ejection period (PEP), decreased left ventricular ejection time (LVET), and accelerated heart rate (HR). These changes were similar in patients with and without heart disease. Halothane and and MS-dTc lowered systolic blood pressure and increased PEP/LVET. With halothane but not with MS-dTc these changes were more pronounced in patients who had heart disease. Changes of the PEP/LVET ratio during halothane anesthesia were a better discriminating variable among patients without, with moderate, and with severe heart disease than were changes in systolic blood pressure.
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PMID:On-line systolic time intervals during anesthesia in patients with and without heart disease. 127 14

Potassium homeostasis was studied in 30 patients undergoing cardiac surgery by employing cardiopulmonary bypass (CPB) and moderate hypothermia, and using morphine, N2O, relaxant anaesthesia. There was a trend for hypokalemia, and for maintaining a K+ level of 4-4.5 mmol/l, K+ infusion was required during CPB (9.017 mmol/m2 BSA/h). K+ infusion required in the post-operative period was considerably less (1.532 mmol/m2 BSA/h). There was no significant difference in the K+ levels of patients receiving preoperative diuretic therapy, as compared to those not receiving such therapy. Potassium requirement was significantly higher in patients under-going CABG and valvular heart disease, as compared to congenital heart disease. The mean urinary loss of K+ during bypass was found to be 2.95 mmol/m2 BSA/h, which was only 32 per cent of that required to be infused (9.017 mmol/m2 BSA/h). The mean excretion of K+ in the post operative period was significantly higher (4.53 mmol/m2 BSA/h) than K+ required to be infused during this period (1.532 mmol/m2 BSA/h).
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PMID:Potassium homeostasis during & after cardiopulmonary bypass. 207 59

Changes in plasma level of arginine vasopressin (AVP), arterial pressure, and urine flow were studied before, during and after cardiopulmonary bypass (CPB) in 11 patients with congenital heart disease. Anesthesia was induced with thiopental sodium (3-5 mg/kg) and was maintained with enflurane (1.0-1.5%), 50% N2O in O2 and morphine (0.5 mg/kg). Concentration of plasma AVP increased slightly from 3.8 +/- 1.5 pg/ml after induction and increased 3-fold after sternotomy. Plasma AVP level increased to 132 +/- 26 pg/ml and 218 +/- 54 pg/ml after 5 and 60 min on CPB, respectively. When the circulation returned to normal, plasma AVP level decreased gradually but was still significantly higher at 24 hr (13.4 +/- 2.5 pg/ml). Marked osmolar diuresis was induced with mannitol in the priming solution used during the CPB: increases in urine flow, Na excretion and osmolar clearance. Possible mechanisms of marked increase in AVP release and differences of AVP responses during CPB reported by other investigators are discussed.
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PMID:Responses of vasopressin release in patients with cardiopulmonary bypass anesthetized with enflurane and morphine. 259 63

We describe a seven-compartment physiologic model of inhalational anesthetic induction with circulatory shunts that was used to simulate inhalational anesthetic induction in children with congenital heart disease. Our conclusions based on this model are that left-to-right (L-R) shunting has little effect on speed of induction; right-to-left (R-L) shunting significantly slows induction of N2O and halothane anesthesia; and adding an L-R shunt to a preexisting R-L shunt will attenuate the slowing of induction caused by the R-L shunt.
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PMID:Effect of left-to-right, mixed left-to-right, and right-to-left shunts on inhalational anesthetic induction in children: a computer model. 397 Mar 55

Haemodynamic incidence of induction of anaesthesia was evaluated in four groups of 10 patients in general surgery: patients without heart disease (gr. I), patients with ischaemic myocardiopathy (gr. II, gr. IV), patients with ischaemic heart disease who were digitalized before anaesthesis (gr. III). An anaesthetic technique comprising a combination of phenoperidine, thiopentone, suxamethonium, pancuronium, N2O/O2 was used in groups I, II, III and patients of group IV were anaesthetized with a protocol of narconeuroleptanalgesia (phenoperidine, droperidol, thiopentone, pancuronium, N2O/O2). Induction of anaesthesia in patient with ischaemic myocardiopathy leads to haemodynamic changes with a predominant decrease of mean arterial pressure. But the haemodynamic changes are less important with neuroleptanalgesia than with balanced anaesthesia. With neuroleptanalgesia decrease of mean arterial pressure is rather less important than with balanced anaesthesia and it is not coupled with a significant decrease of cardiac index but only with a decrease of total peripheral resistances. On contrary with balanced anaesthesia decrease of mean arterial pressure is connected with a significant decrease of cardiac index related to a decrease of systolic index. Pre-operative digitalization do not attenuate cardiac and haemodynamic changes occurring after induction and balanced anaesthesia. Though neuroleptanalgesia appears to be a safe technique in patients with ischaemic heart disease.
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PMID:[Induction of anaesthesia. Haemodynamic incidence in patients with ischaemic myocardiopathy (author's transl)]. 746 50

Data were collected from a retrospective audit in anaesthetists members of the French Association of Anaesthetists in Paediatrics (ADARPEF) and from the prospective study of the author's practice of appendectomy using open or laparoscopic surgery. Retrospective data obtained in 9 of the 16 answering centres show that contraindications include respiratory disability, cardiopathy and age lower than 5 years when surgical instruments of proper size are not available. Monitoring included electrocardioscope, non invasive arterial pressure, pulse oximetry and capnography. Three centres excluded halothane due to possible cardiovascular concern. In two institutions N2O was omitted to limit the size of potential gas embolism. Intraoperative events included high PETCO2 (37%), high arterial pressure (10%), low arterial pressure (3%), bradycardia (1%), hypoxia (0.5%) and one case of pneumothorax. In the appendectomy series, laparoscopy increased the duration of the procedure, and therefore intraoperative opioids requirements. Arterial pressure was higher in this group, irrespective to intraabdominal pressure and to PETCO2. No significant improvement in postoperative analgesia was found. It is therefore recommended to pay special attention to intraoperative anaesthetic and surgical management of children undergoing laparoscopic surgery, particularly in newborns and infants. The high incidence of minor intraoperative adverse events should be balanced by increased postoperative benefit to the patient which has not yet been demonstrated in children.
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PMID:[Laparoscopic surgery in pediatrics: the point of view of the anesthetist]. 837 18

A 13-month-old girl with cyanotic congenital heart disease; single atrium, single ventricle, common atrioventricular (AV) valve, pulmonary atresia and total anomalous pulmonary venous drainage, suspected of asplenia underwent ear tube surgery for otitis media. She had undergone bilateral Blalock-Taussig shunts for her heart disease. She had congestive heart failure due to moderate to severe common AV valve regurgitation and often experienced respiratory tract infection with sputum. Oxyhemoglobin saturation measured by pulse oximetry was 75-80% and polycythemia was found in complete blood count. We chose tracheal intubation for her airway management because of a large amount of sputum. General anesthesia was maintained with sevoflurane, nitrous oxide and oxygen for ear tube surgery. During anesthesia she showed several episodes of desaturation which were well managed by frequent tracheal suctioning. Her circulation was stable with 50% N2O and sevoflurane 1.7-2.0%. The operation was performed uneventfully and the patient was discharged to the ward after tracheal extubation. Asplenia is frequently complicated with cyanotic congenital heart disease and increased susceptibility to bacterial infection. Anesthesia for these patients with upper respiratory infection should be managed with tracheal intubation even for a short surgery.
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PMID:[Anesthetic management of an infant with asplenia and single atrium single ventricle undergoing ear tube surgery for otitis media: a case report]. 1579 12