Anesthesiology
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Biography Historical Article
Photographs of early ether anesthesia in Boston: the Daguerreotypes of Albert Southworth and Josiah Hawes.
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The modifying effects of fentanyl on protective airway reflexes have not been characterized in children. The aim of this study was to assess the impact of increasing doses of fentanyl on laryngeal reflex responses in children anesthetized with sevoflurane. The authors hypothesized that the incidence of laryngospasm evoked by laryngeal stimulation is reduced with increasing doses of fentanyl. ⋯ Two successive doses of 1.5 microg/kg fentanyl did not effectively prevent laryngospasm in children, aged 2-6 yr, anesthetized with sevoflurane.
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Tracheal intubation-associated events (TIAEs) are common (20%) and life threatening (4%) in pediatric intensive care units. Physician trainees are required to learn tracheal intubation during intensive care unit rotations. The authors hypothesized that "just-in-time" simulation-based intubation refresher training would improve resident participation, success, and decrease TIAEs. ⋯ Brief just-in-time multidisciplinary simulation-based intubation refresher training did not improve the resident's first attempt or overall tracheal intubation success.
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Mechanical ventilation still causes an unacceptably high rate of morbidity and mortality because of ventilator-induced lung injury (VILI). Therefore, new therapeutic strategies are needed to treat VILI. Hydrogen sulfide can induce hypothermia and suspended animation-like states in mice. Hydrogen sulfide can also confer antiinflammatory and antiapoptotic effects. This study investigates the organ-protective effects of inhaled hydrogen sulfide during mechanical ventilation. ⋯ Inhalation of hydrogen sulfide during mechanical ventilation protects against VILI by the inhibition of inflammatory and apoptotic responses. Hydrogen sulfide confers lung protection independently of its ability to induce mild hypothermia during ventilation.