European journal of anaesthesiology
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The clinical applications of xenon for the neonate include both anaesthesia and neuroprotection. However, due to the limited natural availability of xenon, special equipment is required to administer and recapture the gas to develop xenon as a therapeutic agent. ⋯ Stable gas delivery to a piglet with minimal xenon loss and analogue circuitry made the xenon recirculating ventilator easy to use and it could be modified for other large animals and noble gas mixtures. The technologies, safety and efficiency of xenon delivery in this preclinical system have been taken forward in the development of neonatal ventilators for clinical use in phase II clinical trials for xenon-augmented hypothermia and for xenon anaesthesia.
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Some anaesthetics exert an inhibitory effect on the response of the carotid body to low oxygen tension. However, the effect of dexmedetomidine on the carotid body response has not been reported. ⋯ Dexmedetomidine does not depress the activity of the carotid body under high oxygen tension or the response to low oxygen tension, whereas 0.1 nmol l dexmedetomidine facilitates this response via α2-adrenergic receptor activation.
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Although the overall outcome of patients undergoing renal transplant surgery has improved in recent years, delayed graft function and myocardial infarction remain common and severe postoperative complications. This review article provides an update on anaesthesia for renal transplant surgery in order to optimise perioperative therapy and improve the outcome of these patients. ⋯ Care for the living donor, commonly used drugs and their potential nephrotoxic properties are discussed. Finally, the current knowledge about volume therapy, optimised haemodynamic management and postoperative care is described.