European journal of anaesthesiology
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Randomized Controlled Trial Comparative Study
Low flow desflurane and sevoflurane anaesthesia in children.
Low flow desflurane and sevoflurane anaesthesia were administered to children and compared for haemodynamic response, renal and hepatic function, recovery time and postoperative nausea and vomiting. ⋯ Low flow desflurane and sevoflurane anaesthesia do not adversely affect haemodynamic parameters, hepatic and renal function in children. Desflurane may be preferred when early recovery from anaesthesia is warranted.
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We decided to investigate the pathogenesis of pulmonary ventilatory and radiographic abnormalities in patients after major vascular surgery. ⋯ Our data suggest that mild, subclinical, pulmonary oedema is relatively common after major vascular surgery, mainly caused by increased pulmonary capillary permeability in the absence of overt heart failure. However, permeability oedema only partially contributes to postoperative lung injury score and need for mechanical ventilation, suggesting a major contribution by atelectasis.
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Randomized Controlled Trial Comparative Study
Comparison of the modified Airway Management Device with the Proseal laryngeal mask airway in patients undergoing gynaecological procedures.
The modified Airway Management Device (AMD) and the Proseal laryngeal mask airway (PLMA) are both supraglottic airway devices designed to maintain airway patency and allow ventilation during anaesthesia. In this prospective, randomized trial, we compared the two devices in patients undergoing major gynaecological procedures. ⋯ The modified AMD has a significant lower first time successful placement rate, required a longer insertion time and has a lower oropharyngeal leak pressure than the PLMA. It also demonstrated an increased loss of airway during anaesthesia. The modified AMD needs further evaluation on its efficacy and safety before its further use can be recommended.
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Comparative Study
Comparison of invasive and less-invasive techniques of cardiac output measurement under different haemodynamic conditions in a pig model.
Despite the introduction of various less-invasive concepts of cardiac output measurement, pulmonary arterial thermodilution is still the most common measurement technique. ⋯ Our data suggest that pulmonary arterial thermodilution and PiCCO may be interchangeably used for cardiac output measurement even under acute haemodynamic changes. The method described by Bland and Altman demonstrated an overestimation of cardiac output for both thermodilution methods. HemoSonic and NICO offer non-invasive alternatives and complementary monitoring tools in numerous clinical situations. Trend monitoring and haemodynamic optimizing can be applied sufficiently, when absolute measures are judged critically in a clinical context. The use of the NICO system seems to be limited during acute circulatory changes.
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We tested the feasibility of using the intubating laryngeal mask airway Fastrach (ILMA) as a ventilatory device and for flexible lightwand-guided tracheal intubation for out-of-hospital cardiopulmonary resuscitation by an emergency physician. ⋯ The intubating laryngeal mask airway has a high success rate as a ventilatory device and as a flexible lightwand-guided airway intubator during out-of-hospital cardiopulmonary resuscitation by a well-trained emergency physician. This technique may be particularly useful when there is limited access to the head and neck.