European journal of anaesthesiology
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Comparative Study
Flow rate, syringe size and architecture are critical to start-up performance of syringe pumps.
Significant start-up delays are inherent to syringe infusion pumps, particularly at low infusion rates, as routinely used in children's anaesthesia and intensive care. Such delays are mainly the result of engagement of gears in the mechanical drive or compliance of the syringe assembly. The purpose of the present study was to determine the effect of flow rate, syringe size and syringe architecture on fluid delivery during infusion start-up. ⋯ Highest possible flow rate, smaller sized syringes and syringe plungers with reduced compressibility should be preferred in order to avoid significant start-up delays in fluid delivery.
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Although a considerable amount of promising experimental research has been performed on cardiopulmonary resuscitation, clinical data indicate an ongoing limited outcome in human beings. One reason for this discrepancy could be that experimental studies use healthy animals whereas most human beings undergoing cardiopulmonary resuscitation suffer from acute or chronic myocardial dysfunction. To overcome this problem, we sought to develop a new model of myocardial infarction, that is easy to perform in all kind of laboratories and compromises on the myocardial function significantly. ⋯ These data demonstrate that clipping of the circumflex artery leads to a reduced myocardial performance after successful resuscitation, whereas the rate of restoration of spontaneous circulation is not reduced. Therefore, this set-up provides a reproducible model for future studies of post-resuscitation haemodynamics and treatment.
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The Section and Board of Anaesthesiology of the European Union of Medical Specialists aims (EUMS/UEMS) at harmonization of training of anaesthesiologists and at improvement of patient care throughout Europe. Pain medicine is considered to be an area of expertise in anaesthesiology although exclusivity is not claimed. ⋯ These proposals were prepared by the Working Party on Pain Medicine of the Section and Board. It considers a multidisciplinary approach to pain to contribute to quality in care and has taken the initiative to set up a Multidisciplinary Joint Committee on Pain Medicine within the EUMS/UEMS, for which these guidelines define the area of expertise of anaesthesiology.
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Randomized Controlled Trial
Comparison of laryngeal tube with laryngeal mask airway in anaesthetized and paralysed patients.
The laryngeal mask has become a widely accepted alternative to endotracheal intubation and mask ventilation. The laryngeal tube is a relatively new supraglottic airway device for airway management. We compared the new version of the laryngeal tube with the laryngeal mask. ⋯ With respect to clinical function, the new version of the laryngeal tube and the laryngeal mask are similar and either device can be used to establish a safe and effective airway in paralysed patients.
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The postoperative monitoring and treatment of the patient undergoing aortic valve replacement is a complex challenge. Echocardiography is the only method which provides dynamic and real-time bedside imaging of the heart. Focused assessed transthoracic echocardiography has been shown to provide a usable window for cardiac imaging in a mixed ICU population. The aim of this study was to evaluate the feasibility of perioperative imaging of the heart and pleura according to the focused assessed transthoracic echocardiography protocol in patients scheduled for aortic valve replacement. ⋯ We conclude that the image quality of the heart and pleura, according to the focused assessed transthoracic echocardiography concept, is sufficient to undergo interpretation and thereby contribute to the perioperative clinical decision-making in patients with aortic stenosis.