Anesthesia and analgesia
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Anesthesia and analgesia · Dec 2009
Randomized Controlled Trial Comparative Study Retracted PublicationCardiopulmonary bypass priming using a high dose of a balanced hydroxyethyl starch versus an albumin-based priming strategy.
The optimal priming solution for cardiopulmonary bypass (CPB) is unclear. In this study, we evaluated the influence of high-volume priming with a modern balanced hydroxyethyl starch (HES) preparation on coagulation, inflammation, and organ function compared with an albumin-based CPB priming regimen. ⋯ High-volume priming of the CPB circuit with a modern balanced HES solution resulted in reduced inflammation, less endothelial damage, and fewer alterations in renal tubular integrity compared with an albumin-based priming. Coagulation including platelet function was better preserved with high-dose balanced HES CPB priming compared with albumin-based CPB priming.
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Anesthesia and analgesia · Dec 2009
Comparative StudyA comparison of transmittance and reflectance pulse oximetry during vascular surgery.
New reflectance pulse oximetry probes placed on the forehead may be an improvement over transmittance probes placed on a finger, toe, or earlobe in patients with compromised perfusion. We compared the reliability and accuracy of the 2 types of probes in patients undergoing vascular surgery. ⋯ The new reflectance forehead Spo(2) probe tested has acceptable agreement with the older transmittance probe placed on the earlobe for pulse oximetry within typical ranges of Spo(2) in patients undergoing vascular surgery.
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Anesthesia and analgesia · Dec 2009
Need for emergency surgical airway reduced by a comprehensive difficult airway program.
Inability to intubate and ventilate patients with respiratory failure is associated with significant morbidity and mortality. A patient is considered to have a difficult airway if an anesthesiologist or other health care provider experienced in airway management is unable to ventilate the patient's lungs using bag-mask ventilation and/or is unable to intubate the trachea using direct laryngoscopy. ⋯ A comprehensive difficult airway program was associated with a reduction in the number of emergency surgical airway procedures performed for the inability of an anesthesiologist to intubate and ventilate, a reduction that was sustained over an 11-yr period. This decrease occurred despite an increase in the number of patients reported to have a difficult airway and an overall increase in the total number of patients receiving anesthesia per year.