B2 Spirometry肺量计
C1 tachycardia心动过速 innominate artery 无名动脉
C2
0.5-mg increments of midazolam and/or 10 µg of remifentanyl boluses 。10 µg/kg的瑞芬bolus你敢用?
C4 接下来就很悲剧了,译者没弄清楚单肺通气期(OLV)nondependent/dependent的专指,上/下肺以及非通气肺/通气肺,术侧肺,开胸侧肺~~~~后面是相当的凌乱啊。
C5 气管tracheal,支气管bronchial要分清。ETTs 就是气管导管的意思,哎 Several techniques can be used to provide OLV: conventional ETTs passed endobronchially, special single-lumen ETTs with incorporated bronchial blocking catheters (Univent endotracheal tube), bronchial blocking catheters passed outside or inside the ETT, and double-lumen endobronchial tubes.
C7 A left-sided DLT is preferable for most procedures because the origin of the right upper lobe (RUL) approximately 0.5 to 1.0 cm below the carina complicates placement of a right-sided tube.中文说反了,左侧DLT之所以更受欢迎,主要是RUL开口距离隆突太近,还有置入左支气管的安全范围更大providing a greater margin for error in positioning。
C8 实质上标志是找RUL 的开口,因为此时用FOB一般须翘起前端寻找,解剖决定的,所以是takeoff 。looking for the RUL takeoff (which usually arises from the lateral aspect of right mainstem bronchus just below the tracheal carina) DLT分为tracheal lumen和bronchial lumen,所以才叫双腔管,可惜译者又弄混淆了。更要命的是气管,气管导管(tube),堵塞管(catheter)双腔管(lumen)混在一起了。读书的同学飞机就是这样坐上的:dizzy:
C9 stylet管芯不是探针
Advantages. Bronchial blockers are relatively simple and can be used in children and adults who are too small for DLTs. Also, they can facilitate OLV in patients with a difficult airway or where a DLT is contraindicated;
be placed through an existing single-lumen ETT in emergent situations; eliminate the need to change ETTs for postoperative mechanical ventilation.
C10 PtcO2 不是CO2
C13 反了The presence of disease in the dependent lung will decrease the ability of accepting redistribution of blood flow, thereby decreasing the HPV effect of the nondependent lung.
Surgical interference with blood flow to the nondependent lung also decreases the anesthetic effect on HPV.
C15 Ventilate manually to determine whether higher or lower tidal volumes/inspiratory pressures are beneficial.手控不是人工通气,俗称捏皮球。
Set minute ventilation to maintain PaCO2at 40 mm Hg (hypocapnia may inhibit HPV in the nondependent lung; hyperventilation may increase airway pressure and promote blood flow to the nonventilated lung).上肺
Insufflate oxygen to the nonventilated lung—a flow of approximately 3 L per minute allowed to circulate freely will often increase arterial oxygen saturation by 3% to 4%.漏了
Apply PEEP of 5 cm H2O to the dependent lung—it may be beneficial if larger tidal volumes delivered manually improved arterial saturation (i.e., recruitable alveoli). Alternatively, if tidal volumes are too large, adding PEEP may overdistend alveoli that are already open and compress blood vessels, diverting blood to the nonventilated lung and worsening the shunt.前提是如果你膨下肺(肺泡复张)可提高动脉血氧饱和度,反之则过犹不及的意思。
Partially re-expand the nonventilated lung and then cease ventilation but keep the lumen to the nonventilated side closed. This could interfere with surgical exposure.这个but没有转折的意思,lumen是双腔管的管腔。
the deflation phase of a large tidal volume breath to overcome critical opening pressures in the atelectatic lung 复张期
optimal (best) end-expiratory pressure 最佳PEEP
C16 spontaneous ventilation 自主呼吸avoids the potential hazards of positive pressure on the suture lines of the new bronchial stump or parenchymal air leaks, the combination of modest CPAP and pressure support ventilation PSV is usually preferable to controlled intermittent mandatory ventilation. IPPV/IMV (CMV)
D2 narcotic 麻醉性镇痛药,主要是指阿片一类。Neuraxial主要意思是椎管内
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