European journal of anaesthesiology
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Randomized Controlled Trial Clinical Trial
Can first responders achieve and maintain normocapnia when sequentially ventilating with a bag-valve device and two oxygen-driven resuscitators? A controlled clinical trial in 104 patients.
To evaluate the capability of first responders to achieve and maintain normal ventilation of the lungs of victims employing a bag-valve device and two oxygen-driven resuscitators. ⋯ The use of an oxygen-driven device improves the ability of first responders to achieve and maintain normocapnia even when distracted. Use of the Oxylators improves performance (P < 0.001) vs. the bag-valve device significantly.
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Sepsis is an infection-induced syndrome characterized by a generalized inflammatory state. The normal reaction to infection involves a series of complex immunological processes. A potent, complex immunological cascade ensures a prompt protective response to microbial invasion in human beings. ⋯ Infected fluid collections and/or infected necrotic tissues should be drained or debrided without delay. Adequate nutritional support is indicated in the management of the septic patient. A number of adjuvant therapies, aimed at blunting/downregulating the host immune response to bacterial infection are currently under intensive investigation; however, the complexity of immunological defences and the potential for complementary interaction of the different components of the inflammatory cascade make the development of these pharmacological interventions difficult.
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Unplanned hospital admission is a measure of quality of care in the setting of day-case surgery. We set out to identify the incidence and causes of unplanned hospital admission in a paediatric day-case unit. ⋯ This study demonstrated that the incidence and causes of unplanned hospital admission following day-case surgery in children are similar to those for adults.
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Comparative Study
Can we rely on arterial line sampling in performing activated plasma thromboplastin time after cardiac surgery?
Arterial catheters are routinely used to sample blood for clotting studies in most cardiothoracic intensive care units. The clotting profile in surgical bleeding after cardiac surgery influences further management. Aspiration and discard of a certain amount of blood from the line, prior to sampling, are assumed to clear heparin contamination. We have investigated this assumption through analysis of the clotting profile by simultaneous arterial line and peripheral venous samples. ⋯ Samples withdrawn from heparinized arterial lines cannot be relied upon for APTT ratio results.
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A randomized, blind study to evaluate the effects on beta-endorphin and substance P release after washing acid burns with 0.9% saline, calcium gluconate or diphoterine in a model of chemical burn in rats. ⋯ Skin flushing with diphoterine reduced substance P release during the first 48 h after burn, and was associated with better wound healing and higher concentrations of beta-endorphin 7 days later when compared with normal saline or 10% calcium gluconate.