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Biomedical subjects

H Mandøe

Publications and source records attributed to H Mandøe.

6 recordsLinked to original sources

Reduced arterial O2 saturation during supine exercise in highly trained cyclists.

Performance of intense dynamic exercise in highly trained athletes is associated with a reduced arterial haemoglobin saturation for O2 (SaO2) and lower arterial PO2 (PaO2). We hypothesized that compared with upright exercise, supine exercise would be accompanied by a smaller reduction in SaO2 because of a lower maximal O2 uptake (VO2max) and/or a more even ventilation-perfusion distribution. Eight elite bicyclists completed progressive cycle ergometry to exhaustion in both positions with concomitant determinations of ventilatory data, arterial blood gases and pH. During upright cycling VO2max averaged 75 +/- 1.6 mL O2 min-1 kg-1 (+/-SEM) and it was 10.6 +/- 1.7% lower during supine cycling (P < 0.001). Also the maximal pulmonary and alveolar ventilation were lower during supine cycling (by 15 +/- 2% and 21 +/- 3%, respectively; P < 0.001) which related to a 0.8 +/- 0.1 L lower tidal volume (P < 0.001). In all subjects and independent of work posture PaO2 and SaO2 decreased from rest to exhaustion (from 99 +/- 3 to 82 +/- 2 Torr and 98.1 +/- 0.2 to 95.2 +/- 0.4%, respectively; P < 0.001); alveolar-arterial PO2 difference increased from 6 +/- 2 to 37 +/- 3 Torr in both body positions. At exhaustion arterial PCO2 was lower in upright than in supine (33.4 +/- 0.6 vs. 35.9 +/- 0.9 Torr; P < 0.01), suggesting a greater relative hyperventilation in upright. Arterial pH was similar in upright and supine at rest (both 7.41 +/- 0.01) and at exhaustion (7.31 +/- 0.01 vs. 7.32 +/- 0.01, respectively). We conclude that despite a lower Vo2max and supposedly an improved ventilation-perfusion distribution, altering body position from upright to supine does not influence arterial O2 desaturation during intense exercise.

Adult↗

[Midazolam and lorazepam as premedication. A randomized double-blind study].

Oral administration of midazolam and lorazepam as premedication was compared in a double-blind randomized clinical trial. Eighty patients scheduled for minor gynaecological surgery in general anaesthesia and 80 patients scheduled for hip arthroplasty in spinal anaesthesia were included. Assessments were: 1. patients subjective evaluation of the premedication, 2. sedation scale, 3. recovery of cognitive function assessed by Simple Paper-and-Pencil test and Postbox test, 4. amnesic effects. In the general anaesthesia group midazolam caused less postoperative sedation, less postoperative amnesia and cognitive function returned more rapidly. In the spinal anaesthesia group cognitive function returned more rapidly after midazolam. Midazolam should be preferred for premedication if rapid recovery is desired.

Administration, Oral↗

[Poisoning with petroleum preparations--again!].

Accidentally occurring hydrocarbon poisoning during early childhood is a frequent and in most cases benign event. Nevertheless there is a potential risk of more serious consequences. We describe such a case. Respiratory symptoms are of the greatest concern. They include cough, tachypnoea, and in the more serious cases cyanosis and respiratory failure. Moreover, symptoms from the gastrointestinal tract are common. Treatment includes prevention of aspiration, symptomatic treatment and in more serious cases respiratory support.

Accidents, Home↗

[Fasting times, ventricular aspiration and use of antacids and H2 blockaders at Danish departments of anesthesiology].

In a questionnaire sent to 58 anaesthetic departments in Denmark (1992/93), we assessed fasting guidelines, preoperative gastric emptying and the use of pharmacological aspiration prophylaxis. Replies were obtained from 51 departments (88%). Most departments (90%) fast adults for at least six hours prior to elective surgery. However, 14 departments (27%) plan to change their guidelines to allow the intake of clear liquid on the day of surgery. Eighteen departments (35%) hardly ever use preoperative gastric emptying prior to emergency surgery. The other departments differ as to when gastric emptying should be performed. Only few departments (25%) employ pharmacological prophylaxis.

Adolescent↗

Sore throat after endotracheal intubation.

Nitrous oxide can diffuse into the cuff of an endotracheal tube during tracheal intubation, and the cuff pressure against the tracheal wall may cause mucosal damage. An endotracheal tube has been developed (Brandt Anesthesia Tube) that effectively limits nitrous oxide-related intracuff pressure increases. We determined whether the incidence of postoperative sore throat could be reduced by using this tube. Forty-eight female patients, 18-50 yr of age, were included in the study. Endotracheal intubation was performed with either a Brandt Anesthesia Tube or a Mallinckrodt endotracheal tube. All patients were interviewed postoperatively after 20-30 h by individuals who did not know which tube was used. In the Mallinckrodt group, 12 of 20 patients had a sore throat and 10 patients had intracuff pressures greater than 25 mm Hg. Only 3 of 20 patients in the Brandt group had a sore throat. We found that the incidence of sore throats after intubation could be significantly reduced by using the Brandt Anesthesia Tube (P less than 0.005).

Adolescent↗

[Capnometry. Technique and clinical use in anesthesia and emergency medicine].

By capnometry is understood measurement of carbon dioxide in the expiratory air. The concentration can be determined by various forms of spectometry. A new acoustic principle of measurement is more sensitive than the methods hitherto employed. Capnometry registers rapid intubation of the oesophagus. Sudden changes in expired carbon dioxide may be signs of malignant hyperthermia or pulmonary embolism. In addition, capnometry is a valuable aid in the regulation of mechanical ventilation. Recent investigations suggest that capnometry can be employed to confirm or refute clinical suspicion of pulmonary embolism and that measurement of expired carbon dioxide may be of prognostic value in resuscitation. It has not yet be elucidated whether nasal measurements in patients who are not intubated can provide reliable values.

Anesthesia↗