European journal of anaesthesiology
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Editorial Comment
A new era for troponins in clinical practice guidelines.
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An expressed and constant wish of the first author's oldest daughter to enhance interaction with her favourite toy animal led to a (re)animation/resuscitation attempt of a 1½-year-old stuffed plush bunny. Initial physical examination found no vital signs. Based on the lack of identifiable airways, we hypothesised that tissue oxygenation might be caused by passive diffusion throughout the body. ⋯ Multimodal monitoring of arterial blood pressure (by proxy), intra-'cranial' pressure and oxygen tension, near-infrared spectroscopy of the head and laser-Doppler blood flow was successfully initiated, whereas an attempt at intracranial microdialysis was unsuccessful. Despite achieving measurable arterial blood pressure (by proxy) (12/3 mmHg) and an increase of cerebral perfusion by 30 points, spontaneous circulation or diffusion was not achieved apparently, and ultimately, animation attempts were ceased. Clinical experience, as well as common sense, forces us to conclude that our measurements were contaminated by the intervention, and that we must rethink the method for the animation of stuffed plush bunnies.
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Comment Letter
Regional anaesthesia in patients on antithrombotic drugs.