Anesthesia and analgesia
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Anesthesia and analgesia · Apr 2010
Clinical TrialA nasal catheter for the measurement of end-tidal carbon dioxide in spontaneously breathing patients: a preliminary evaluation.
Several devices have been proposed to monitor end-tidal carbon dioxide tension (Petco(2)) in spontaneously breathing patients; however, many have been reported to be inaccurate. We designed this study to investigate the accuracy of a balloon-tipped nasal catheter in measuring Petco(2) in nontracheally intubated, spontaneously breathing patients. ⋯ Our results suggest that a balloon-tipped nasal catheter can provide a simple, easy, and reliable method for Petco(2) measurement in nontracheally intubated, spontaneously breathing patients.
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Anesthesia and analgesia · Apr 2010
Randomized Controlled Trial Comparative StudyLaryngeal mask airway or endotracheal tube for percutaneous dilatational tracheostomy: a comparison of visibility of intratracheal structures.
Some severe complications during percutaneous dilatational tracheostomy (PDT) may be related to poor visualization of tracheal structures. Subjectively, the bronchoscopical view obtained via a laryngeal mask airway (LMA) seems to be better than that obtained with an endotracheal tube (ETT). In this prospective, randomized study, we compared LMA and ETT as the ventilatory device during PDT mainly with respect to visualization of tracheal structures. The quality of ventilation and airway-related complications are also reported. ⋯ The LMA technique showed definite advantages regarding visualization of relevant tracheal structures and the dilation process compared with an ETT. This may be especially relevant in the hands of inexperienced intensivists and in cases of difficult patient anatomy where improved structural visualization optimizes operating conditions.
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Anesthesia and analgesia · Apr 2010
Meta AnalysisCochrane corner: hypothermia for neuroprotection in adults after cardiopulmonary resuscitation.
Good neurologic outcome after cardiac arrest is hard to achieve. Interventions during the resuscitation phase and treatment within the first hours after the event are critical. Experimental evidence suggests that therapeutic hypothermia is beneficial, and a number of clinical studies on this subject have been published. ⋯ Conventional cooling methods to induce mild therapeutic hypothermia seem to improve survival and neurologic outcome after cardiac arrest. Our review supports the current best medical practice as recommended by the International Resuscitation Guidelines.
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Anesthesia and analgesia · Apr 2010
Meta AnalysisCochrane corner: sugammadex, a selective reversal medication for preventing postoperative residual neuromuscular blockade.
Sugammadex is the first selective relaxant binding agent that has been studied for reversal of neuromuscular blockade induced by rocuronium and other steroidal non-depolarizing neuromuscular blocking agents (NMBAs). ⋯ Sugammadex was shown to be effective in reversing rocuronium-induced neuromuscular blockade. This review has found no evidence of a difference in the instance of unwanted effects between sugammadex, placebo or neostigmine. These results need to be confirmed by future trials on larger patient populations and with more focus on patient-related outcomes.