European journal of anaesthesiology
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Comparative Study
Comparison of electrical velocimetry and transthoracic thermodilution technique for cardiac output assessment in critically ill patients.
The results of studies validating the assessment of cardiac output by pulmonary artery thermodilution and a modified algorithm using thoracic bioimpedance/electrical velocimetry in patients undergoing elective cardiac surgery are conflicting. The present observational study was designed to detect whether electrical velocimetry measurements are comparable to transthoracic thermodilution in septic patients after major general surgery. ⋯ There was poor agreement between the values of cardiac output estimation by transthoracic thermodilution and those by electrical velocimetry. Electrical velocimetry could not replace invasive monitoring in this trial.
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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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Letter Case Reports
Cranial nerve injuries from a laryngeal mask airway.