European journal of anaesthesiology
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Randomized Controlled Trial
Influence of intravenous thiamine supplementation on blood lactate concentration prior to cardiac surgery: A double-blinded, randomised controlled pilot study.
Stress related to surgery and critical illness depletes thiamine, essential in energy metabolism, and might result in high blood lactate concentrations and higher mortality. ⋯ Thiamine supplementation caused normalisation of blood and urine concentrations postoperatively but without a significant reduction in lactate concentration or clinical outcome. Body composition played an important role in lactate formation. Further research focusing on preoperative screening and optimal treatment of high lactate concentrations in this specific population is warranted.
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Comparative Study Observational Study
Comparing charcoal and zeolite reflection filters for volatile anaesthetics: A laboratory evaluation.
A modified heat-moisture exchanger that incorporates a reflecting filter for use with partial rebreathing of exhaled volatile anaesthetics has been commercially available since the 1990 s. The main advantages of the device are efficient delivery of inhaled sedation to intensive care patients and reduced anaesthetic consumption during anaesthesia. However, elevated arterial CO2 values have been observed with an anaesthetic conserving device compared with a conventional heat and moisture exchanger, despite compensation for larger apparatus dead space. ⋯ Charcoal and zeolite possess gas-reflecting properties, which can be used to conserve volatile anaesthetics. They also reflect CO2. The degree of CO2 reflection was reduced by heating and humidifying the air.
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Clinical Trial Observational Study
Increased tracheal cuff pressure during insertion of a transoesophageal echocardiography probe: A prospective, observational study.
Excessive tracheal cuff pressure reduces tracheal mucosal blood flow and increases tracheal morbidity. Inserting a transoesophageal echocardiography (TOE) probe has been shown to increase tracheal cuff pressure. ⋯ Insertion of a TOE probe increased tracheal cuff pressure in both the SLT and DLT groups. The increase in cuff pressure was greater in patients who received a DLT. Frequent measurement and adjustment of cuff pressure should be emphasised particularly when TOE is used in patients receiving a DLT.