European journal of anaesthesiology
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Randomized Controlled Trial
The efficacy of high flow nasal oxygenation for maintaining maternal oxygenation during rapid sequence induction in pregnancy: A prospective randomised clinical trial.
High-flow nasal oxygenation (HFNO) for pre-oxygenation in rapid sequence induction (RSI) has only been assessed in volunteer parturients without intubation. ⋯ Compared with SFM, HFNO provided a higher PaO2 and EtO2 immediately after intubation in parturients. HFNO is safe as a method of oxygenation during RSI in parturients undergoing general anaesthesia for caesarean section.
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Various strategies have been used to mitigate haemodynamic instability during general anaesthesia for caesarean section. However, the safety of these strategies for neonates remains controversial. ⋯ In our study, Apgar score at 1 min reported using both quantitative and categorical variables were lower in the remifentanil group than in the dexmedetomidine group but TSA showed that these differences were inconclusive for categorical variables. Data for other outcomes were scarce and did not allow any conclusions to be drawn. Thus, further studies with larger numbers of parturients and with neonatal outcomes as a primary endpoint are warranted to clarify the effects of intravenous dexmedetomidine and remifentanil.
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Randomized Controlled Trial
Effects of positive end-expiratory pressure/recruitment manoeuvres compared with zero end-expiratory pressure on atelectasis in children as tracked by ultrasound: A randomised clinical trial.
Atelectasis is a common postoperative complication. Peri-operative lung protection can reduce atelectasis; however, it is not clear whether this persists into the postoperative period. ⋯ The reduced atelectasis provided by lung-protective ventilation does not persist from 15 min after extubation onwards. Further studies are needed to determine if it yields better results in other types of surgery.
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Fast delivery of high-quality cardiopulmonary resuscitation is crucial in improving patient outcome after out of hospital cardiac arrest. First responders (trained laypersons) are dispatched to shorten time to basic life support and can be organised in groups or individually. ⋯ Team spirit and peer-support engages group first responders, whereas individual first responders are impaired by lack of social support. Involvement with society triggers both first responder types to become and stay first responders. As first responders in groups have substantial additional benefits, enhancing such groups might strengthen current first responder systems.