Serum Cpk, LDH and Their Isoenzymes in the Perioperative Period in Patients Undergoing Craniotomy

Tabatabai, M.; Wong, K.; Tadjziechy, M.; Kirimli, Bülent; Navalgund, A.; Javadi, Pardis; Price, G.

doi:10.1097/00000542-198909001-00150

Cited by 2 publications

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“…However, we did not observe any evidence of compression injuries and the mild increase in serum CPK concentration noted in the two groups of patients was small. This increase in muscle enzymes has been noted by others after paediatric surgical procedures without compression of the lower body [19].…”

Section: Discussionsupporting

confidence: 78%

“…However, recent studies have suggested that PEEP does not reverse the normal inter-atrial gradient, but the sudden increase in venous return when PEEP is discontinued may be responsible for the abrupt increase in right (relative to left) atrial pressure [25,28]. The MAST suit increases right and left atrial pressures to a similar extent [13,19] and therefore the combination of lower body compression and PEEP may be expected to preserve the normal inter-atrial pressure gradient. It has been suggested that echocardiography be used to detect patent foramen ovale before surgical procedures are performed in the sitting position and the presence of a patent foramen ovale should be considered as a contraindication to this position [29].…”

Section: Discussionmentioning

confidence: 99%

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Prevention of venous air embolism in paediatric neurosurgical procedures performed in the sitting position by combined use of MAST suit and PEEP

Meyer¹,

Cuttaree²,

Charron³

et al. 1994

British Journal of Anaesthesia

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We studied 60 children undergoing neurosurgical procedures in the sitting position. Routine monitoring included ECG, pulse oximetry, invasive arterial pressure, in particular mean arterial pressure (MAP), and right atrial pressure (RAP). Children were allocated to two groups. In group B lower body positive pressure and positive end-expiratory pressure (PEEP) were used for preventing venous air embolism (VAE). In this group, antishock trousers (MAST suit) were adjusted in supine children. After induction of anaesthesia, different positions were studied: supine and sitting before MAST suit inflation, sitting with MAST suit inflated up to a pressure of 40 mmHg in the lower compartments and 30 mmHg in the abdominal compartment, and finally a combination of lower body positive pressure and PEEP of 8-10 cm H2O. In group A no MAST suit or PEEP was used. Continuous monitoring of end-tidal carbon dioxide pressure throughout (PE'CO2) was used to detect VAE. In order to evaluate the transmission of pressures from the right atrium to the veins at the base of the skull, jugular bulb venous pressure (JBVP) was measured in 20 patients by retrograde catheterization. The incidence of VAE was compared in the two groups. On placing children into the sitting position, a significant decrease in RAP and JBVP was noted without significant changes in MAP in the two groups. Inflation of the MAST suit induced a dramatic increase in RAP and JBVP, reinforced by addition of PEEP. There was a strong positive relationship between RAP and JBVP. There were no deleterious side effects or differences between the two groups in peroperative blood product requirements or surgical general conditions.(ABSTRACT TRUNCATED AT 250 WORDS)

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Section: Discussionsupporting

confidence: 78%