Evaluation of Cardiopulmonary Risk under Midazolam Sedation: Discussion (Part 4)
Major arrhythmias were noticed in 5 percent of the patients, which agrees with a number of studies in spontaneously breathing patients, but is lower than the 40 percent rate observed by Katz et al. In the latter report, arrhythmias were frequently associated with a period of major oxygen desaturation of up to 44 percent. Such hypoxemia was not present in our patients; the mean SaO2 was 97 percent (range, 93 to 100 percent) in the six patients suffering arrhythmias.
In conclusion, this study has shown that fiberoptic bronchoscopy is practicable in critically ill intubated patients. In the present series of 107 ventilated patients, no death or cardiac arrest occurred during or within the two hours immediately following the procedure; however, patients in the ICU are at risk of relative hypoxemia during fiberoptic bronchoscopy even when high levels of oxygen are provided to the ventilator and gas leaks around the endoscope are minimized by a special adapter. Patients with ARDS are obviously at higher risk of definite hypoxemia. Careful methodic attention to the anesthetic protocol, ventilator settings, and monitoring of patients during bronchoscopy should permit rapid correction and more frequent prevention of hypoxemia and should further decrease morbidity. It’s time for you to start saving some money: you just need to visit the pharmacy that offers finest quality Purchase Cheap Claritin with delivery straight to your door and all the confidentiality guarantees you ever need.