麻醉英文病例演讲比赛
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remifentanil-plus-sevoflurane-controlled hypotension
• Blood pressure dropped steadily without rebound hypertension[2] • Reducing cerebral oxygen metabolismand facilitating brain protection[3]
Discussion
• Our concerns ？ • Response plans ？ • Optimization-based methods ？
Response plans
• Interventional wenku.baidu.commbolization • Balloon ductal dilatation technique • Autologous Blood Salvage Technique • (preoperative autologous blood donation ,PAD) • (Acute Hpervolaemic Haemodilution, AHH) • (Acute Normovolaemic Haemodilution, ANH) • Preoperative blood preparation • controlled hypotension
Controlled Hypotension, CH
• Controlled hypotension is defined as a reduction of the systolic blood pressure to 8090 mm Hg, a reduction of mean arterial pressure (MAP) to 50-65 mm Hg or a 30% reduction of baseline MAP[1].
Response plans
• Interventional Embolization • Balloon ductal dilatation technique • Autologous Blood Salvage Technique • Preoperative autologous blood donation ,PAD • Acute Hpervolaemic Haemodilution, AHH • Acute Normovolaemic Haemodilution, ANH • Preoperative blood preparation • Controlled hypotension
Perioperative management of giant abdominal tumor resection
汇报人：董瑞 青岛市市立医院东院区 麻醉科
Case history
• A 27-year-old female，Diagnosis of giant abdominal tumors • T：36.5℃ P ：70 beats per minute R：15 beats per minute BP：115/76mmHg • H:165cm W：53kg BMI: 19.47 • ECG and cardiac ultrasound are normal • Laboratory examination ： blood, urine, Coagulation function ，kidney and liver function were all among
undergoing cardiac surgery[3] • Provides a superior blood product[4]
[1]. Goldberg J et al. Ann Thorac Surg 2015, 100(5):1581-1587. [2]. Guo JR et al.Asian Pac J Cancer Prev 2013, 14(8):4529-4532. [3]. Society of Thoracic Surgeons Blood Conservation Guideline Task Fet al. Ann Thorac Surg 2011, 91(3):944-982. [4].孙立新.我们熟悉的内环境.青岛市麻醉学分会.2017,10,28
normal range • Abdominal CT : There is a huge soft tissue mass between the peritoneum and the left kidney,
17*11.8*19cm
• ASA status Ⅰ ， Mallampati grade Ⅰ，Cardiac function grade Ⅱ
indicated. • A cost-effective blood conservation technique • Blood infusion: in reverse order of collection
ANH
• Reduction of perioperative component transfusion[1] • Not influencecoagulation function[2] • Improved tissue perfusion, greater convenience for the patient • The AACA uses ANH as a blood protection strategy for patients
ANH
• A technique used to reduce red blood cells (RBCs) lost during surgery. • During ANH, blood is drawn from a patient prior to surgery, while
restoring the circulating blood volume with acellular fluid. • Collected blood is reinfused after blood loss has ceased, or sooner if
• Blood pressure dropped steadily without rebound hypertension[2] • Reducing cerebral oxygen metabolismand facilitating brain protection[3]
Discussion
• Our concerns ？ • Response plans ？ • Optimization-based methods ？
Response plans
• Interventional wenku.baidu.commbolization • Balloon ductal dilatation technique • Autologous Blood Salvage Technique • (preoperative autologous blood donation ,PAD) • (Acute Hpervolaemic Haemodilution, AHH) • (Acute Normovolaemic Haemodilution, ANH) • Preoperative blood preparation • controlled hypotension
Controlled Hypotension, CH
• Controlled hypotension is defined as a reduction of the systolic blood pressure to 8090 mm Hg, a reduction of mean arterial pressure (MAP) to 50-65 mm Hg or a 30% reduction of baseline MAP[1].
Response plans
• Interventional Embolization • Balloon ductal dilatation technique • Autologous Blood Salvage Technique • Preoperative autologous blood donation ,PAD • Acute Hpervolaemic Haemodilution, AHH • Acute Normovolaemic Haemodilution, ANH • Preoperative blood preparation • Controlled hypotension
Perioperative management of giant abdominal tumor resection
汇报人：董瑞 青岛市市立医院东院区 麻醉科
Case history
• A 27-year-old female，Diagnosis of giant abdominal tumors • T：36.5℃ P ：70 beats per minute R：15 beats per minute BP：115/76mmHg • H:165cm W：53kg BMI: 19.47 • ECG and cardiac ultrasound are normal • Laboratory examination ： blood, urine, Coagulation function ，kidney and liver function were all among
undergoing cardiac surgery[3] • Provides a superior blood product[4]
[1]. Goldberg J et al. Ann Thorac Surg 2015, 100(5):1581-1587. [2]. Guo JR et al.Asian Pac J Cancer Prev 2013, 14(8):4529-4532. [3]. Society of Thoracic Surgeons Blood Conservation Guideline Task Fet al. Ann Thorac Surg 2011, 91(3):944-982. [4].孙立新.我们熟悉的内环境.青岛市麻醉学分会.2017,10,28
normal range • Abdominal CT : There is a huge soft tissue mass between the peritoneum and the left kidney,
17*11.8*19cm
• ASA status Ⅰ ， Mallampati grade Ⅰ，Cardiac function grade Ⅱ
indicated. • A cost-effective blood conservation technique • Blood infusion: in reverse order of collection
ANH
• Reduction of perioperative component transfusion[1] • Not influencecoagulation function[2] • Improved tissue perfusion, greater convenience for the patient • The AACA uses ANH as a blood protection strategy for patients
ANH
• A technique used to reduce red blood cells (RBCs) lost during surgery. • During ANH, blood is drawn from a patient prior to surgery, while
restoring the circulating blood volume with acellular fluid. • Collected blood is reinfused after blood loss has ceased, or sooner if