European journal of anaesthesiology
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Comparative Study
Continuous right ventricular end-diastolic volume in comparison with left ventricular end-diastolic area.
Intraoperative management of patients with end-stage liver disease undergoing liver transplantation requires fluid administration to increase cardiac output and oxygen delivery to the tissues. Filling pressures have been widely shown to correlate poorly with changes in cardiac output in the critically ill patient. Continuous right ventricular end-diastolic volume index (cRVEDVI) and left ventricular end-diastolic area index (LVEDAI) monitoring have been increasingly used for preload assessment. The aim of this study was to compare cRVEDVI, LVEDAI, central venous pressure and pulmonary artery occlusion pressure with respect to stroke volume index (SVI) during liver transplantation. ⋯ cRVEDVI and LVEDAI gave a better reflection of preload than filling pressure, even if only cRVEDVI reached statistical significance.
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Randomized Controlled Trial Comparative Study
Comparison of the effect of propofol and N-acetyl cysteine in preventing ischaemia-reperfusion injury.
The aim of this study was to compare the effects of propofol and N-acetyl cysteine (NAC) on tourniquet-induced ischaemia-reperfusion injury by determining malonyldialdehyde, ischaemia-modified albumin, lactate, blood gas and haemodynamic levels in arthroscopic knee surgery. ⋯ Small-dose infusions of both propofol and NAC appear to provide similar protection against ischaemia-reperfusion injury in arthroscopic knee surgery.
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Randomized Controlled Trial
Effects of changes in blood pressure and airway pressures on parameters of fluid responsiveness.
Systolic pressure variation (SPV) and stroke volume variation (SVV) are clinical indicators of fluid responsiveness. However, several factors may influence these parameters and thereby limit their usefulness. In this clinical study, we analysed SPV and SVV in comparison with static preload parameters during an increase in arterial blood pressure (BP) and airway pressure. ⋯ In cardiac surgical patients with preserved cardiac index, SVV, but not SPV, decreased during an acute increase in BP, whereas both parameters, in contrast to cardiac filling pressures, significantly increased with higher tidal volume.
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Neuraxial anaesthesia has been shown to produce a sedative and anaesthetic-sparing effect. The purpose of the present study was to determine the effects of acute spinal cord injury on sevoflurane requirement and stress hormone responses during spinal surgery at the level of the injury. ⋯ Spinal cord injury neither alters the anaesthetic requirement regardless of the level of injury during spinal surgery at the level of the injury, nor enhances arginine vasopressin release. However, it blunts catecholamine responses in quadriplegics.