European journal of anaesthesiology
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Comparative Study
Survival after long-term isoflurane sedation as opposed to intravenous sedation in critically ill surgical patients.
Isoflurane has shown better control of intensive care sedation than propofol or midazolam and seems to be a useful alternative. However, its effect on survival remains unclear. ⋯ Compared with propofol/midazolam sedation, long-term sedation with isoflurane seems to be well tolerated in this group of critically ill patients after surgery.
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Comparative Study
Fluid replacement and respiratory function: comparison of whole blood with colloid and crystalloid: A randomised animal study.
Fluid replacement with blood products, colloids and crystalloids is associated with morbidity and mortality. Despite this, the consequences of fluid administration on airway and respiratory tissue properties are not fully understood. ⋯ This model, which mimics surgical haemorrhage, yields no evidence of a difference between colloids and crystalloids with regard to the pulmonary consequences of blood volume restoration. Functional changes in the lung should not be a key concern when choosing fluid replacement therapy with these solutions.
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Observational Study
The relationship between pulmonary artery acceleration time and mean pulmonary artery pressure in patients undergoing cardiac surgery: An observational study.
A noninvasive method of estimating pulmonary arterial pressures is required, as the use of the pulmonary artery catheter (PAC) is decreasing in cardiac anaesthesia. Pulmonary hypertension is defined as a mean pulmonary artery pressure (MPAP) at least 25 mmHg and this can be estimated echocardiographically by measuring the pulmonary acceleration time (PAT). This relationship has not been validated when measured using transoesophageal echocardiography (TOE) in anaesthetised patients having cardiac surgery. ⋯ Estimation of PAT with TOE in anaesthetised cardiac surgical patients is possible. PAT is good at discriminating between patients with and without pulmonary hypertension, with a cut-off of less than 107 ms detecting pulmonary hypertension with a sensitivity of 75% and specificity of 94.8%.
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Observational Study
Life-threatening complications after postoperative intermediate care unit discharge: A retrospective, observational study.
Postoperative patients who require intensive monitoring, intervention with an arterial line, vasoactive drugs and prolonged ventilator weaning are admitted to the postoperative intermediate care unit (IMCU). ⋯ More than 1% of patients had a life-threatening complication within 7 days after IMCU discharge, but with no deaths. Risk factors were an emergency operation before IMCU admission, higher cumulative perioperative fluid load and a short period of mechanical ventilation during the IMCU stay.
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Editorial Biography Historical Article
History of anaesthesia: Amedeo Avogadro (1776-1856) - Do his accomplishments match his reputation?