RESUMEN
The use of extracorporeal membrane oxygenation in adults has increased in popularity and importance for the support of patients with cardiac or pulmonary failure. Although it is now quite commonly used in the intensive care unit, its use has rarely been described as a means of support during anaesthesia and surgery. We report the case of a patient who required curative resection of the oesophagus following previous left pneumonectomy where veno-venous extracorporeal membrane oxygenation was required both during surgery and for the first three days postoperatively. We describe the anaesthetic management of this patient who only had a single lung, review other alternatives and discuss why extracorporeal membrane oxygenation was particularly suited to this case. To the best of our knowledge, the anaesthetic literature to date does not contain a case report of this type.
Asunto(s)
Anestesia General , Carcinoma de Células Escamosas/cirugía , Esofagectomía/métodos , Oxigenación por Membrana Extracorpórea/métodos , Anciano , Dióxido de Carbono/sangre , Neoplasias Esofágicas/cirugía , Humanos , Masculino , EspirometríaRESUMEN
In order to quantify the force acting in the capsular bag following implantation of an intraocular lens (IOL), 58 J- and C-loop lenses obtained from four different manufactures were implanted into the capsular bag in porcine eyes. The cornea and iris were removed before implantation. Photographs of the capsular bag before and after implantation, with a measuring rod for comparison, were taken under a microscope. In this way, the compression of the haptics could be measured (mean 1.7 mm, standard deviation 0.6 mm). Afterwards one haptic of each lens was fixed in a special mount placed on a high precision scale and the opposite haptic was compressed by 2 mm using a special micrometer-screw. After 5 min compression time, differences of 300% between the different manufacturers and lens types were measured. To find out whether the differences measured have an influence on the deformation of the capsular bag, a graph was plotted with force measured and values for elongation of the capsular bag along the axes. In this way a correlation of the elongation and the force could be shown. The results show that besides shaping the haptics of IOLs, the force necessary to compress the haptics also has an influence on the final form of the capsular bag.