Anesthesia and analgesia
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Anesthesia and analgesia · Aug 2009
Randomized Controlled TrialThe effect of intravenous alanyl-glutamine supplementation on plasma glutathione levels in intensive care unit trauma patients receiving enteral nutrition: the results of a randomized controlled trial.
We sought to investigate the effect of IV alanyl-glutamine supplementation on plasma glutathione levels in severely traumatized patients receiving enteral nutrition. ⋯ This study demonstrates that IV alanyl-glutamine supplementation for 7 days increases total plasma glutathione levels in critically ill trauma patients receiving standard enteral nutrition.
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Anesthesia and analgesia · Aug 2009
Comparative StudyA comparison of stroke volume variation measured by Vigileo/FloTrac system and aortic Doppler echocardiography.
The goal of this study was to compare stroke volume variation (SVV) assessed from a peripheral artery with the Vigileo/FloTrac system (SVV-FloTrac) with SVV derived close to the heart by aortic Doppler (SVV-Doppler). ⋯ SVV-FloTrac and SVV-Doppler measurements show acceptable bias and limits of agreement, and similar performance in terms of fluid responsiveness in patients undergoing liver transplantation.
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Anesthesia and analgesia · Aug 2009
The effects of steep trendelenburg positioning on intraocular pressure during robotic radical prostatectomy.
Intraocular pressure (IOP) increases in steep Trendelenburg positioning, but the magnitude of the increase has not been quantified. In addition, the factors contributing to this increase have not been studied in robot-assisted prostatectomy cases. In this study, we sought to quantify the changes in IOP and examine perioperative factors responsible for these changes while patients are in the steep Trendelenburg position during robotic prostatectomy. ⋯ IOP reached peak levels at the end of steep Trendelenburg position (T5), on average 13 mm Hg higher than the preanesthesia induction (T1) value. Surgical duration and ETco(2) were the only significant predictors of IOP increase in the Trendelenburg position (T4-T5).
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Anesthesia and analgesia · Aug 2009
An expiratory assist during spontaneous breathing can compensate for endotracheal tube resistance.
Although inspiratory assist of spontaneous breathing in intubated patients is common, expiratory assist functions have rarely been reported. Effective expiratory support (ES) could be used to compensate for endotracheal tube (ETT) resistance during spontaneous breathing. In this study, we examined the performance of a new system designed to provide both inspiratory support (IS) and ES during spontaneous breathing with the goal of reducing the effective resistance of the ETT. ⋯ In this study of healthy volunteers, IS plus ES compensated for the airway resistance imposed by a ID 5.0 mm ETT to create pressure changes at the tip of the ETT similar to those of an ID 8.0 mm ETT.
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Anesthesia and analgesia · Aug 2009
Nosocomial contamination of laryngoscope handles: challenging current guidelines.
Laryngoscope blades are often cleaned between cases according to well-defined protocols. However, despite evidence that laryngoscope handles could be a source of nosocomial infection, neither our institution nor the American Society of Anesthesiologists has any specific guidelines for handle disinfection. We hypothesized that laryngoscope handles may be sufficiently contaminated with bacteria and viruses to justify the implementation of new handle-cleaning protocols. ⋯ We found a high incidence of bacterial contamination of laryngoscope handles despite low-level disinfection. However, no vancomycin-resistant enterococci, methicillin-resistant S. aureus, Gram-negative rods, or respiratory viruses were detected. Our results support adoption of guidelines that include, at a minimum, mandatory low-level disinfection of laryngoscope handles after each patient use.