European journal of anaesthesiology
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The Difficult Airway Society protocol for the 'can't intubate, can't ventilate' scenario recommends the use of kink-resistant cannula cricothyroidotomy with transtracheal jet ventilation or surgical cricothyroidotomy. This survey aimed to assess the preparedness of anaesthetists and anaesthetic assistants for emergency tracheal access. ⋯ There were widespread deficits in 'can't intubate, can't ventilate' knowledge and skills. All participants received a demonstration of equipment, were shown the location and given the opportunity to rehearse a 'can't intubate, can't ventilate' drill.
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Sevoflurane anaesthetic preconditioning (SPC) has been shown to limit nuclear factor-[kappa]B (NF-[kappa]B) activation and the production of inflammatory cytokines during myocardial ischaemia/reperfusion (I/R). Similarly, pharmacological inhibition of NF-[kappa]B using parthenolide is effective in limiting I/R injury. We, therefore, postulated that the protective effect of delayed SPC would be enhanced by pharmacological NF-[kappa]B inhibition during I/R. ⋯ SPC followed by parthenolide provides a significant protection from I/R injury in this model. As each intervention alone limits NF-[kappa]B activation with I/R, these data are consistent with additive effects of these dual modalities in limiting I/R injury due to NF-[kappa]B activation.