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001-es BibID:	BIBFORM076718
Első szerző:	Nemes Réka (aneszteziológus, intenzív terápiás szakorvos)
Cím:	Performance Assessment of a New Electromyography-based Neuromuscular Monitor and Subjective Discomfort in Unmedicated Volunteers / Nemes Reka, Dioszeghy Boglarka, Pongracz Adrienn, Tassonyi Edomer, Fulesdi Bela
Dátum:	2018
ISSN:	2155-6148 2155-6148
Megjegyzések:	Objective: The aim of this prospective, unblinded, randomized study was to provide performance data of the prototype of new electromyography-based neuromuscular monitor, the NEAT device (Acacia Designs BV, Amsterdam, the Netherlands) and assess the subjective discomfort associated with neurostimulation in unmedicated healthy volunteers. Methods: The study enrolled ten male and ten female volunteers. Based on a priori randomization the ulnar nerve of the left or right arms was stimulated in 1 Hz single twitch and train-of-four modes. Stimulating current intensity was increased from 10 mA to 60 mA in 10 mA steps. Electromyography recordings were performed at the abductor digiti minimi and adductor pollicis muscles via surface electrodes. The volunteers were asked to rate the discomfort in association with neurostimulation on a 0-10 visual analogue scale. Results: The overall train-of-four ratio was 1.02 (0.98-1.06) {median and (interquartile range)}. The abductor digiti minimi muscle required lower stimulating current intensity to evoke maximal stimulation, than the adductor pollicis (30 vs. 50 mA, p <0.001). The overall intracurrent variability of compound muscle action potential amplitudes was 0.42 (0.21-0.87) mV, that was unaffected by the type of muscle or the stimulating current intensity. Women reported moderately higher visual analogue scale scores than men. The largest recorded difference was 5 (3.75-6) vs. 3 (3-4), p <0.05. Conclusion: The Acacia Designs BV NEAT monitoring device was suitable to deliver neurostimulation, record and analyze the elicited muscle action potentials. The precision of stimulations was acceptable. The volunteers reported the discomfort in association with neurostimulation as tolerable. Registered at the Hungarian Office for Health Authorization and Administrative Procedures (December 30th, 2014). Identifier: 028605-010/2014/OTIG. Registered at clinicaltrials.gov (December 15th, 2015). Identifier: NCT02630576.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban Neuromuscular monitoring Electromyography Visual analogue scoring scale Abductor digiti minimi muscle Adductor pollicis muscle
Megjelenés:	Journal of Anesthesia and Clinical Research. - 9 : 8 (2018), p. 1-8. -
További szerzők:	Diószeghy Boglárka Pongrácz Adrienn (1971-) (aneszteziológus, intenzív terápiás szakorvos) Tassonyi Edömér (1940-2022) (aneszteziológus) Fülesdi Béla (1961-) (aneszteziológus)
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001-es BibID:	BIBFORM120123
035-os BibID:	(scopus)85189692529
Első szerző:	Szamos Katalin
Cím:	One-lung ventilation with fixed and variable tidal volumes on oxygenation and pulmonary outcomes : a randomized trial / Szamos Katalin, Balla Boglárka, Pálóczi Balázs, Enyedi Attila, Sessler Daniel I., Fülesdi Béla, Végh Tamás
Dátum:	2024
ISSN:	0952-8180
Megjegyzések:	A B S T R A C T Objective: Test the hypothesis that one-lung ventilation with variable tidal volume improves intraoperative oxygenation and reduces postoperative pulmonary complications after lung resection. Background: Constant tidal volume and respiratory rate ventilation can lead to atelectasis. Animal and human ARDS studies indicate that oxygenation improves with variable tidal volumes. Since one-lung ventilation shares characteristics with ARDS, we tested the hypothesis that one-lung ventilation with variable tidal volume improves intraoperative oxygenation and reduces postoperative pulmonary complications after lung resection. Design: Randomized trial. Setting: Operating rooms and a post-anesthesia care unit. Patients: Adults having elective open or video-assisted thoracoscopic lung resection surgery with general anesthesia were randomly assigned to intraoperative ventilation with fixed (n = 70) or with variable (n = 70) tidal volumes. Interventions: Patients assigned to fixed ventilation had a tidal volume of 6 ml/kgPBW, whereas those assigned to variable ventilation had tidal volumes ranging from 6 ml/kg PBW ? 33% which varied randomly at 5-min intervals. Measurements: The primary outcome was intraoperative oxygenation; secondary outcomes were postoperative pulmonary complications, mortality within 90 days of surgery, heart rate, and SpO2/FiO2 ratio. Results: Data from 128 patients were analyzed with 65 assigned to fixed-tidal volume ventilation and 63 to variable-tidal volume ventilation. The time-weighted average PaO2 during one-lung ventilation was 176 (86) mmHg in patients ventilated with fixed-tidal volume and 147 (72) mmHg in the patients ventilated with variable-tidal volume, a difference that was statistically significant (p < 0.01) but less than our pre-defined clinically meaningful threshold of 50 mmHg. At least one composite complication occurred in 11 (17%) of patients ventilated with variable-tidal volume and in 17 (26%) of patients assigned to fixed-tidal volume ventilation, with a relative risk of 0.67 (95% CI 0.34?1.31, p = 0.24). Atelectasis in the ventilated lung was less common with variable-tidal volumes (4.7%) than fixed-tidal volumes (20%) in the initial three postoperative days, with a relative risk of 0.24 (95% CI 0.01?0.8, p = 0.02), but there were no significant late postoperative differences. No other secondary outcomes were both statistically significant and clinically meaningful.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban folyóiratcikk Thoracic anesthesia One-lung ventilation Tidal volume Postoperative pulmonary complications Intraoperative oxygenation Variable ventilation
Megjelenés:	Journal Of Clinical Anesthesia. - 95 (2024), p. 1-9. -
További szerzők:	Balla Boglárka Pálóczi Balázs Enyedi Attila (1975-) (sebész) Sessler, Daniel I. Fülesdi Béla (1961-) (aneszteziológus) Végh Tamás (1975-) (aneszteziológus, intenzív terápiás szakorvos)
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001-es BibID:	BIBFORM060681
Első szerző:	Tankó Béla (aneszteziológus)
Cím:	Occupational Hazards of Halogenated Volatile Anesthetics and their Prevention : review of the Literature / Béla Tankó, Levente Molnár, Béla Fülesdi, Csilla Molnár
Dátum:	2014
ISSN:	2155-6148
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban Volatile anesthetics Halogenated gases
Megjelenés:	Journal of Anesthesia & Clinical Research. - 5 : 7 (2014), p. 1-7. -
További szerzők:	Molnár Levente Fülesdi Béla (1961-) (aneszteziológus) Molnár Csilla (1962-) (aneszteziológus)
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