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Biomedical subjects

Edmond Cohen

Publications and source records attributed to Edmond Cohen.

8 recordsLinked to original sources
PubMed2005

The Cohen flexitip endobronchial blocker: an alternative to a double lumen tube.

One-lung ventilation (OLV) is usually achieved by the use of a double-lumen tubes (DLTs). With increasing need for use of OLV for video-assisted thoracoscopic procedures, the limitations of traditional DLT's, including difficult insertion and positioning, have become evident. This has led to renewed interest in devising alternative methods of achieving lung separation, such as the Univent tube or Arndt endobronchial blocker. This report describes the technical features and clinical use of a new tip-deflecting endobronchial blocker.

Aged↗
PubMed2004

Double-lumen tube position should be confirmed by fiberoptic bronchoscopy.

PURPOSE OF REVIEW: This review is part of Pro and Contra use of fiberoptic bronchoscopy to confirm the position of a double lumen tube. The purpose of this review is to highlight the circumstances where fiberoptic bronchoscopy should be used in conjunction with lung separation, right sided double-lumen tube positioning, and to identify fine malposition for generally missed by clinical signs. RECENT FINDINGS: Until several years ago, confirmation of a double-lumen tube (DLT) position was limited to inspection and auscultation. Fiberoptic bronchoscopes were usually only available in the bronchoscope suite for the exclusive use of the pulmonary personnel. Today, in most institutions, fiberoptic bronchoscopes of different diameters are available in the operating room for use by the anesthesia personnel. SUMMARY: Advances in technology and improved quality of the endoscopes image make the technique easy to use with a relatively simple learning curve. In fact, fiberoptic workshops, thoracic workshops and difficult airway workshops are offered in nearly all important anesthesia meetings.

Journal Article↗
PubMed2003

Executive summary from the Intraoperative Advisory Council on Donation After Cardiac Death of the United Network for Organ Sharing: practice guidelines.

The number of organs recovered from asystolic donors is less than anticipated and is explained partially by negative attitudes held by health care providers. To understand the reasons for these beliefs and find solutions, the United Network for Organ Sharing under contract with the Department of Health and Human Services convened the Intraoperative Advisory Council on Donation After Cardiac Death in September, 2001. The Council found that, unlike other medical specialties, operating room health care providers were uncertain of their roles and duties in the care of donors declared dead with cardiopulmonary criteria, known as donation after cardiac death. They were reluctant to care for terminally ill patients in whom death was an expected outcome. Council members deliberated these issues, seeking solutions to repatriate operating room health care providers with the national effort to provide reliable and compassionate care to organ donors and their families. The Council requested the construction of practice guidelines, believing that the structure provided by guidelines will improve health provider confidence in donation after cardiac death and thus improve the quality of care. Physician and nonphysician health care providers from the operating room met to create the Guidelines for the United Network for Organ Sharing, which they believe will improve the quality of care of asystolic organ donors.

Heart Arrest↗
PubMed2002

Methods of lung separation.

In the last few years, video assisted thoracoscopy, which allows a wide variety of diagnostic and therapeutic procedures, has been introduced into clinical practice. A growing enthusiasm for minimally invasive surgical approaches and improvements in video endoscopic surgical equipment has resulted in the widespread use of this technique. Most video assisted thoracoscopy procedures require a well-collapsed lung and should only be included in the absolute indication for one-lung ventilation. Following placement of a double lumen tube, it is the standard of care to check the tube is positioned correctly using fiberoptic bronchoscopy. The role of the right-sided double lumen tube is discussed in detail in this review. Finally, there are alternatives to the use of the double-lumen tube to achieve lung separation, such as the Univent tube or an independent bronchial blocker. In many situations the double-lumen tube cannot be inserted, due to a difficult airway or at the conclusion of the procedure changing the double lumen tube to a single lumen tube may result in loss of control over the airway. In such situations, it is essential for the anesthesiologists to be familiar with the existing alternatives to the double-lumen tube.

Journal Article↗
PubMedDate not supplied

Preemptive epidural analgesia for thoracic surgery.

The purpose of this study was to determine if preemptive epidural analgesia performed before thoracotomy incision and during the operation reduces postoperative pain. Patients in the treatment group received 8 mL of 0.25% bupivacaine and 2 mL of fentanyl (50 microg/mL) via the epidural route prior to skin incision, followed by an infusion of bupivacaine 0.1% and fentanyl 10 microg/mL at 6 mL/hr. The control group received saline in the epidural. All patients in both groups were dosed with 8 mL of 0.25% bupivacaine and 2 mL of fentanyl 50 microg/mL via the epidural route at the time of the chest closure. The patients in the treatment group required less isoflurane intraoperatively and had lower maximum pain scores in the first 6 hours postoperatively. No significant differences were noted after the first 6 hours.

Analgesia, Epidural↗