Turkish journal of anaesthesiology and reanimation
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Turk J Anaesthesiol Reanim · Dec 2019
Contribution of Capillary Refilling Time and Skin Mottling Score to Predict ICU Admission of Patients with Septic or haemorrhagic Shock Admitted to the Emergency Department: A TRCMARBSAU Study.
In the emergency department (ED), the severity assessment of shock is a fundamental step prior to the admission in the intensive care unit (ICU). As biomarkers are time consuming to evaluate the severity of micro- and macro-circulation alteration, capillary refill time and skin mottling score are two simple, available clinical criteria validated to predict mortality in the ICU. The aim of the present study is to provide clinical evidence that capillary refill time and skin mottling score assessed in the ED also predict ICU admission of patients with septic or haemorrhagic shock. ⋯ The results from the present study will provide clinical evidence on the correlation between the ICU admission and the capillary refill time and the skin mottling score in septic or haemorrhagic shock admitted to the ED. The aim of the present study is to provide two simple, reliable and non-invasive tools for the triage and early orientation of these patients.
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Turk J Anaesthesiol Reanim · Dec 2019
ReviewCurrent Perspectives on Postoperative Cognitive Dysfunction in the Ageing Population.
Postoperative cognitive dysfunction (POCD) is defined as a prolonged cognitive function impairment that occurs within weeks to months of a surgical procedure. It is especially prevalent in the elderly population, leading to increased morbidity and mortality. ⋯ These findings lend an insight into the importance of being cognisant of the higher likelihood of POCD in at-risk patients, including the elderly, and taking precautions to include preoperative and postoperative cognitive testing, careful monitoring during anaesthesia, blood pressure control and early treatment of postoperative complications as they arise. In this review, we provide an update on the current understanding of the pathophysiology leading to POCD, identifying risk factors, prevention and treatment strategies, with a specific focus on the elderly population.
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Turk J Anaesthesiol Reanim · Oct 2019
Fibreoptic Orotracheal Intubation of Obese Patients Using Parker Flex-Tip vs. Standard Endotracheal Tube.
Advancement of the endotracheal tube through a fibreoptic scope can sometimes prove to be challenging in obese patients. The Parker Flex-Tip endotracheal tube was developed with a curved and tapered distal tip to facilitate easier placement in the trachea. This study examined the use of the Parker Flex-Tip tube as compared to standard endotracheal tubes in patients with a body mass index of 30 or greater. ⋯ Parker Flex-Tip endotracheal tube was not superior to the standard endotracheal tubes for fibreoptic intubation in obese patients.
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Turk J Anaesthesiol Reanim · Oct 2019
Effect of Concurrent Lidocaine, Remifentanil and Methylprednisolone Use on the Clinical Effect of Sugammadex under General Anaesthesia in Rats.
In an in vitro study, lidocaine, remifentanil and methylprednisolone produced inclusion complexes with sugammadex, which lead to a decrease in free and active concentrations of sugammadex. When used concurrently with these drugs, it is likely that the time for sugammadex to reverse a neuromuscular blockade is going to be prolonged due to a synergistic pharmacokinetic or pharmacodynamic interaction. The aim of the present study was to investigate whether concurrent use of sugammadex with remifentanil, lidocaine and methylprednisolone led to a decrease in the neuromuscular blockade reversal effect of sugammadex produced with neuromuscular blockade agent (NMBA) rocuronium. ⋯ We suggest that remifentanil and methylprednisolone used concurrently with sugammadex lead to a decrease in sugammadex reversal effect by giving rise to decrease in its free and active concentrations probably via displacement in rats.
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Turk J Anaesthesiol Reanim · Aug 2019
Diagnostic Performance of 6-Point Lung Ultrasound in ICU Patients: A Comparison with Chest X-Ray and CT Thorax.
To evaluate the diagnostic performance of a rapid bedside 6-point lung ultrasonography (LUS) performed by an intensive care unit (ICU) physician for detection of four common pathological conditions of the lung, such as alveolar consolidation, pleural effusion, interstitial syndrome and pneumothorax, in critically ill patients and its comparison with bedside chest X-ray (CXR) and high-resolution computed tomography (CT) scan of the thorax. Volume of pleural effusion measured by LUS and CT thorax was also compared. ⋯ 6-Point LUS can be a useful diagnostic tool and is better than CXR in diagnosing respiratory pathologies in critically ill patients. Owing to the comparable diagnostic performance of LUS and CT scan and with increasing evidence in favour of LUS, the requirement of CT thorax can be reduced. Radiation hazards associated with CXR and CT, as well as potentially risky transfer of patients to CT room, can also be minimised.