European journal of anaesthesiology
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Comparative Study
Balanced hydroxyethylstarch preparations: are they all the same? In-vitro thrombelastometry and whole blood aggregometry.
Haemostasis appears to be less altered with balanced than with unbalanced hydroxyethylstarch (HES) preparations. In a blinded in-vitro coagulation study, the effects of two HESs dissolved in different balanced solutions were measured. ⋯ Our in-vitro studies showed that extreme haemodilution with HES 130/0.42 dissolved in a balanced solution containing calcium was associated with less negative effects on thrombelastometry and platelet aggregation than HES 130/0.4 prepared in a balanced solution without calcium. Gelatin prepared in a nonbalanced solution showed similar effects on coagulation to balanced HES without calcium.
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After observing that the interruption of activated protein C (aPC) treatment after septic shock reversal was not associated with any deleterious effect, we started to suspend the treatment whenever vasopressors were no longer required. We present a report of our data. ⋯ The use of aPC should be considered in septic shock, but its suspension after shock reversal in this small series of patients was not associated with any deleterious effect.
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Randomized Controlled Trial Comparative Study
Comparison of three modes of positive pressure mask ventilation during induction of anaesthesia: a prospective, randomized, crossover study.
Mask ventilation of apnoeic patients may be associated with alveolar hypoventilation, hyperventilation and gastric insufflation, which may be affected by the mode of ventilation during induction of anaesthesia. This study is to compare the effect of three modes of positive pressure mask ventilation during induction of anaesthesia regarding ventilatory variables and gastric insufflation. ⋯ We concluded that in this model of apnoeic patients with an unprotected airway, PCV was associated with lower peak airway pressure which may provide additional patient safety.
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Mathematical coupling may explain in part why cardiac filling volumes obtained by transpulmonary thermodilution may better predict and monitor responses of cardiac output to fluid loading than pressures obtained by pulmonary artery catheters (PACs). ⋯ After coronary surgery, fluid responses can be similarly assessed by intermittent transpulmonary and continuous pulmonary thermodilution methods, in spite of overestimation of CCIp by CItp. Filling pressures are poor monitors of fluid responses and superiority of GEDVI can be caused, at least in part, by mathematical coupling when cardiac volume and output are derived from the same thermodilution curve.
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Letter Case Reports
Cranial nerve injuries from a laryngeal mask airway.