European journal of anaesthesiology
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Letter Case Reports
Cranial subdural haematoma: a rare complication of spinal anaesthesia.
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Recent studies showed that ischaemic postconditioning converted persistent ventricular fibrillation to sinus rhythm. The influence of anaesthetic postconditioning on ventricular fibrillation has not yet been determined. In the present study, we studied the possible effect of sevoflurane postconditioning on persistent reperfusion-induced ventricular fibrillation in the isolated rat heart model. ⋯ Sevoflurane postconditioning possesses strong antiarrhythmic effect against persistent reperfusion-induced ventricular fibrillation. Anaesthetic postconditioning may have the potential to be an antiarrhythmic therapy for reperfusion-related arrhythmias.
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This review examines the science and methodology of blood conservation in modern anaesthetic and surgical practice. Blood transfusion is associated with increased morbidity and mortality in all surgical patients, and the reduction or even elimination of transfusion has been and continues to be the subject of much research. Blood substitutes, despite extensive investigation, have not been proved successful in trials to date, and none have entered clinical practice. ⋯ Autologous blood transfusion has recently fallen in popularity; however, cell salvage is almost ubiquitous in its use throughout Europe. Anaesthetic and surgical techniques may also be refined to improve blood conservation. Blood transfusion guidelines and protocols are strongly recommended, and repetitive audit and education are instrumental in reducing blood transfusion.
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Randomized Controlled Trial Comparative Study
Central venous catheter colonization and catheter-related bloodstream infections in critically ill patients: a comparison between standard and silver-integrated catheters.
Catheter-related bloodstream infections are one of the main complications affecting patients in intensive care units. This prospective, randomized, unblinded, controlled study investigated colonization and infection rates of standard central venous catheters in comparison with the rates for silver-integrated catheters in the intensive care unit. ⋯ Silver-integrated central venous catheters did not prevent catheter colonization and infections in critically ill patients, but there might be a significant difference in the incidence of colonization and infections over time between standard polyurethane and silver-integrated catheters.
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Randomized Controlled Trial Comparative Study
Heart rate/blood pressure response and airway morbidity following tracheal intubation with direct laryngoscopy, GlideScope and Trachlight: a randomized control trial.
Haemodynamic response to tracheal intubation might be detrimental in high-risk patients. Minimizing oropharyngo-laryngeal stimulation or avoiding laryngoscopy may attenuate this response. We hypothesized that intubations performed with GlideScope or Trachlight would generate a lesser haemodynamic response than the conventional method of direct laryngoscopy. The objective of this study was to compare the haemodynamic response following tracheal intubation, using three different techniques of intubation. We also examined postoperative airway morbidities as our secondary outcome. ⋯ There was no benefit of using any of the three intubation techniques for attenuation of haemodynamic changes. There was a higher incidence of airway symptoms associated with Trachlight intubation.