hello..i have been learning about ETT cuff right now,but i am having difficulty with a term "residual volume"..what is it actually?
i have also heard about another term "resting cuff circumference", but i really don't know anything about this too..what does the "resting" mean?

please help me to understand this..thx u
best regards,Jean

hello, i am really curious about this:
1. if there is a patient with a decreased level of consciousness, how can i know if for intubation this patient still needs the induction agent (or even a fentanyl, lidocain) or not ? is it possible if we correlate it with GCS level?

2. Can i know it by checking the absence of eyelid reflex?
and

3. is it possible that a patient needs only some response blunting drug (such as fentanyl or lidocaine iv) without the need of induction agent? thx u

please help answer..sorry for asking lots of questions..i am quiet confuse about this..

warm regards, Jean

hello.. i know that it might be a foolish thing to ask this, but in my place, we are not talking much about this, so my understanding about this basic thing is very little,,

i am learning about oxygen therapy and i realize that it involves talking about inspiratory peak flow rate and minute ventilation...now, my question is :
1. what is the difference between them?
2. why should we consider peak inspiratory flow rate in oxygen therapy?
3. what relationship does the peak inspiratory flow and minute ventilation have? i mean, how can they affect each other?

please help...thx u

hi, i just want to ask : is it true if there is such thing as MAC extubation that we can use as our guideline for performing deep extubation? if there's such thing like that, where could i learn about this? please help...thx u:)

hi, do anyone of u read "anesthesiology"  by Longnecker?
i am quiet interested by the term cytopempsis mentioned in that book...it is interesting because the book is telling us that the cytopempsis is the reason for giving more crystalloid for blood loss ratio..but i don't understand this term quiet well,

i don't understand why increasing extracellular space more compliant would increase the transcapilllary leakage ? shouldn't increasing the extracellular space volume would increase the interstitial hydrostatic pressure?

i have searched in other sources but i can't find anything about this ...could please someone explain it to me? thx u so much :)

here i quote how the book explained about this term

QuoteTraditional approaches to blood replacement have identified a 3:1 ratio of crystalloid to blood loss. This is incorrect. With increasing volumes of crystalloid administration the extracellular space becomes progressively more compliant, resulting in a geometric increase in transcapillary leakage
that volume replacement for blood loss parallels. This process is known
as cytopempsis and principally reflects the progressive hypoalbuminemia associated with volume replacement.

hello, i met a young eclamptic patient a few days ago and she had very often seizure attack despite given MgSO4 preoperatively...so, the decision to terminate the pregnancy was made as soon as possible, ...my teacher decided to manage this patient with General anesthesia with RSI (with muscle relaxant)... During the operation, the patient given maintenance dose muscle relaxant and show no sign of seizure ( but no EEG was available), the MgSO4 stopped during the operation and the baby delivered well (though the neonate wasn't well), and after the operation, the patient transferred immediately to the ICU...
now, my questions are :

1. is that already a right way to manage this patient? i mean, so the patient is having a frequent active seizure...and we know that giving a muscle relaxant (especially the maintenance muscle relaxant) will damp the signs of the seizure...without EEG, how can we know that this patient is having a seizure?
because as i know that the seizure would increase the CMRO2 and it means need more delivery of O2 and it is quiet labile to have if we need the anesthetics still going on (MAP usually quiet low) ..am i right?

2. if i can't use the muscle relaxant in this patient, should i use the awake intubation or fiberoptic intubation instead (considering that a pregnant woman also have some difficult airway)? 

3. Can i still use the MgSO4 intraoperatively to prevent the seizure? how can i combine it with the intraoperative fluid since the MgSO4 would increase the risk of water intoxication (as well as the oxytocin) too?

4. Considering that the eclamptic patient still had a quiet risk of having another seizures in variable few days (or weeks) after the operation....when is the right time to extubate the patient? 

sorry if all those questions are very simple and even might be a silly questions ..i am new to anesthesia and really want to learned anesthesia :) ...please help..thx u :)

regards, Jean

     

1. hello, i am now reading a master piece from Stoelting's "pharmacology and physiology in anesthetic practice" and i found that he mentioned some new term : the elimination half time and half life...though the book mentioned their each own definition, and i have read it again and again, but i still can't see the difference between both of them..can someone please help describe it to me more clearly?

2. oh ya, i want to ask another thing, how can the (next) larger dose of ephedrine can help reducing the tachyphylaxis?
thx u very much...

regards ,Jean :)

hello everyone, i am quiet new in anesthesia and really need help about the anesthesia circle system...

if u don't mind, i have several questions,especially about the dead space in this system:
1. i have read many books that said that "because of the unidirectional valves, the dead space is generally localized only at the Y connector piece"..i don't really understand, how can those unidirectional valves determine the dead space only to the y connector?

2. the breathing tubes have also compliance that will subtract the Tidal volume delivered to the alveoli, so, can we call the breathing tube as dead space also?

3. how can we calculate the FGF and TV of the ventilator in the semi close circle circuit system to compensate for dead space and compliance of the breathing tube?

those are my several questions, please forgive me if those are foolish questions..i 'm new to this...please help..thx a lot