A Higher Tidal Volume May Be Used for Athletes according to Measured FVC

We investigated whether professional athletes may require higher tidal volume (Tv) during mechanical ventilation hypothesizing that they have significantly higher “normal” lung volumes compared to what was predicted and to nonathletes. Measured and predicted spirometric values were recorded in both athletes and nonathletes using a Spirovit SP-1 spirometer (Schiller, Switzerland). Normal Tv (6 mL/kg of predicted body weight) was calculated as a percentage of measured and predicted forced vital capacity (FVC) and the difference (δ) was used to calculate the additional Tv required using the equation: New Tv(TvN)=Tv+(Tv×δ). Professional athletes had significantly higher FVC compared to what was predicted (by 9% in females and 10% in males) and to nonathletes. They may also require a Tv of 6.6 mL/kg for males and 6.5 mL/kg for females during mechanical ventilation. Nonathletes may require a Tv of 5.8 ± 0.1 mL/kg and 6.3 ± 0.1 mL/kg for males and females, respectively. Our findings show that athletes may require additional Tv of 10% (0.6/6 mL/kg) for males and 8.3% (0.5/6 mL/kg) for females during general anesthesia and critical care which needs to be further investigated and tested

IDIOPATHIC NORMAL PRESSURE HYDROCEPHALUS’ OUTCOME AFTER CEREBROSPINAL FLUID SHUNTING

The aim of this study was to evaluate the clinicaloutcome of patients diagnosed with Idiopathic Normal PressureHydrocephalus (INPH) after cerebrospinal fluid (CSF) shunting.Thirty patients diagnosed with INPH were treated with CSFshunting. The patients were evaluated preoperatively and 6months postoperatively, in terms of their clinical outcome of gait,cognitive function and urinary incontinence. Sixteen patients(53%) showed an average improvement of their clinicalsymptoms and 6 months after shunting were able to functionindependently. Ten patients (34%) were able to return to theirevery day functioning. In four patients (16%) there was noclinical improvement. Our data suggest that patients diagnosedwith INPH and subjected to CSF shunting had a significantclinical improvement in the 6-month postoperative follow-up.Positive outcome on patients with INPH after CSF shunting ishighly correlated with immediate and accurate diagnosis basedon the presence of the classic clinical “Adam-triad”, preoperativecerebrospinal fluid pressure monitoring and drainage response