Anesthesiology
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Randomized Controlled Trial Clinical Trial
Additive contribution of nitrous oxide to sevoflurane minimum alveolar concentration for tracheal intubation in children.
To study the interaction between nitrous oxide and sevoflurane during trachea intubation, the authors determined the minimum alveolar concentration of sevoflurane for tracheal intubation (MAC(TI)) with and without nitrous oxide in children. ⋯ We conclude that nitrous oxide and sevoflurane suppress the responses to tracheal intubation in a linear and additive fashion in children.
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Randomized Controlled Trial Comparative Study Clinical Trial
Preoxygenation: comparison of maximal breathing and tidal volume breathing techniques.
Preoxygenation with tidal volume breathing for 3-5 min is recommended by Hamilton and Eastwood. This report compares tidal volume preoxygenation technique with deep breathing techniques for 30-60 s. ⋯ Rapid preoxygenation with the eight deep breaths within 60 s can be used as an alternative to the traditional 3-min technique.
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Randomized Controlled Trial Clinical Trial
Clinical assessment of a plastic optical fiber stylet for human tracheal intubation.
The authors compared the performance of a prototype intubation aid that incorporated plastic illumination and image guides into a stylet with fiberoptic bronchoscopy and direct laryngoscopy for tracheal intubation by novice users. ⋯ Novices using the imaging stylet produce fewer cases of sore throat (compared with direct laryngoscopy) and can intubate faster than when using a bronchoscope in anesthetized adult patients. The imaging stylet may be a useful aid for tracheal intubation, especially for those unable to maintain skills with a bronchoscope.
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Like ischemic preconditioning, certain volatile anesthetics have been shown to reduce the magnitude of ischemia/ reperfusion injury via activation of K+ adenosine triphosphate (ATP)-sensitive (K(ATP)) channels. The purpose of this study was (1) to determine if ischemic preconditioning (IPC) and sevoflurane preconditioning (SPC) increase nitric oxide release and improve coronary vascular function, as well as mechanical and electrical function, if given for only brief intervals before global ischemia of isolated hearts; and (2) to determine if K(ATP) channel antagonism by glibenclamide (GLB) blunts the cardioprotective effects of IPC and SPC. ⋯ Preconditioning with sevoflurane, like IPC, improves not only postischemic contractility, but also basal flow, bradykinin and nitroprusside-induced increases in flow, and effluent [NO] in isolated hearts. The protective effects of both SPC and IPC are reversed by K(ATP) channel antagonism.
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Partial liquid ventilation (PLV) and prone position can improve arterial oxygen tension (PaO2) in acute lung injury (ALI). The authors evaluated additive effects of these techniques in a saline lung lavage model of ALI. ⋯ The authors conclude that combining PLV with prone position exerts additive effects on pulmonary gas exchange in a saline lung lavage model of ALI in medium-sized pigs.