European journal of anaesthesiology
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Randomized Controlled Trial Comparative Study
Wrapping of the legs versus phenylephrine for reducing hypotension in parturients having epidural anaesthesia for caesarean section: a prospective, randomized and double-blind study.
Wrapping of the legs significantly reduces hypotension during regional anaesthesia for caesarean sections. However, most obstetric anaesthetists prefer to use vasoconstrictors for reducing hypotension. We, therefore, compared the haemodynamic effects of wrapping the legs with prophylactic, repeated doses of intravenous phenylephrine in parturients having epidural anaesthesia for elective caesarean sections. ⋯ Wrapping of the legs is a nonpharmacological, prophylactic method with similar blood pressure control to repeated doses of phenylephrine during epidural anaesthesia for caesarean sections.
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Letter Case Reports Comparative Study
Performance of Vigileo and LiDCOplus cardiac output monitors during a prolonged cardiac arrest and resuscitation.
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We studied whether changes in less invasive, noncalibrated pulse-contour cardiac output (by modified ModelFlow, COmf) and derived stroke volume variations (SVV), as well as systolic and pulse pressure variations, predict changes in bolus thermodilution cardiac output (COtd), evoked by continuous and cyclic increases in intrathoracic pressure by increases in positive end-expiratory pressure (PEEP) and tidal volume (Vt), respectively. ⋯ A fall in COmf is more sensitive than a rise in SVV, which is more sensitive than systolic pressure variation and pulse pressure variation, in tracking a fall in COtd during continuous (and not cyclic) increases in intrathoracic pressure, in mechanically ventilated patients after cardiac surgery. This suggests a reduction in biventricular preload as the main factor in decreasing cardiac output and increasing SVV with PEEP.
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In the majority of patients with difficult airways intubated using the Bonfils fibrescope, intubations have been performed under general anaesthesia. Our aim is to report a consecutive series of intubations on awake patients with anticipated difficult airways, performed using the Bonfils fibrescope. ⋯ Our findings confirm that awake intubation with the Bonfils fibrescope is well tolerated and highly successful, even if performed by operators in training, and strengthen the evidence that the Bonfils fibrescope is one of the most promising devices to assist intubation in patients with difficult airways.