《YAO&ARTUSIO麻醉学》勘误贴

钟庆

同楼上感受，
明天结束第一章，科室读书会陆续发现的疑点，无论怎样，即便是翻译错误，查阅过程中翻译还是极大帮助，更正后最终提高了学习。
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C7“在合并缺血性心脏病的哮喘患者”
C8  1.1MAC的七氟烷
C10  Droperidol has an α -blocking effect that may relieve bronchospasm induced by α stimulation. 氟哌利多有α-阻断作用，可缓解由其刺激而引起的支气管痉挛。
C11 However, if high levels of sensory and motor block are required, they may produce severe anxiety and actually incite bronchospasm. 可产生严重焦虑，但是不会出现什么“激动”（中文原文是深度焦虑和激动），局麻药中毒了？
C13 he may develop bucking 这里是“呛咳”，患者可能发生“跃起”吗？麻醉深度浅成这样？
An ICU ventilator can generate inspiratory pressures as high as 120 cm H2O 单位掉了
auto-PEEP 一般不用翻，习惯上还是叫“内源性PEEP”，很少有见“自身PEEP”
High inspiratory flow rate allows for shorter inspiratory time with adequate time for expiration and lower auto-PEEP。比如PB840，A/C模式，VCV时，设定Vt和f,然后调节（减少）吸气时间（或呼气时间），可或得到更高的吸气（峰）流速
C15 氨茶碱很少rarely aminophylline is rarely used for acute bronchospasm
C16 有可能请高年资医师和呼吸内科医师Consultation with senior staff or a physician in pulmonary medicine may be necessary.
C17 Pulmonary edema肺水肿不是气肿，Negative pressure expiration呼气末负压？也就是可能负压行肺水肿？
容量（capacity）和容积（volume）全是反的。记英文和缩写还不易混淆。中文确实很容易混淆。

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第三章，A3中吸入量超过25ml即使吸入PH<2.5应该是大于2.5也可发生Mendelson综合征

钟庆

第二章，错的太多了，不如读麻本教材。
读了第二章，很受伤。
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下周第三章，初读较前面还不错。

以下是二章的部分错误。真的很不严谨。

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 &micro;g of remifentanyl boluses 。10 &micro;g/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

bingxue1971

P65  D9当呼气流速或压力减至呼吸机的设定水平和/或已达预设的吸气时相时，压力支持可以转为呼气相。应该为吸气相吧。