European journal of anaesthesiology
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We retrospectively reviewed the first 25 planned cases of awake craniotomies using the 'asleep-awake' technique, an alternative to the often-used 'asleep-awake-asleep' technique. ⋯ Different methods of anaesthesia have been described, but no method has been shown to be superior. The presented method seems to be a rational and useful technique allowing for modification of tumour resection, if symptoms should develop. The method was well tolerated by the patients.
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Numerous in vitro studies have shown that volatile anaesthetics react with desiccated carbon dioxide (CO2) absorbents to produce carbon monoxide (CO). The effects of anaesthetic concentration, fresh gas flow rate, and the hydration of absorbent or the excretion of CO2 by patients on CO production have also been investigated. This work aims to identify the most significant one of these factors on CO concentration in a low-flow anaesthesia system, without control of the hydration of the absorbents. ⋯ In clinical practice, the CO2 production varies among patients and is uncontrollable, but markedly affects CO production. The only controllable factor is the fresh gas flow rate if the ultimate goal is to reduce the undesirable exposure of patients to CO from the breathing tube according to this bench model without counting the oxygen consumption.
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Comparative Study
Arterial blood gas derangement and level of comorbidity are not predictors of long-term mortality of COPD patients treated with mechanical ventilation.
Limited and inconsistent data exist on simple, readily available predictors of long-term mortality of critically ill chronic obstructive pulmonary disease patients requiring invasive mechanical ventilation. We therefore examined the influence of arterial blood gas derangement and burden of comorbidities on 90-day and 1-yr mortality of chronic obstructive pulmonary disease patients treated with invasive mechanical ventilation. ⋯ Chronic obstructive pulmonary disease patients treated with invasive mechanical ventilation have substantial long-term mortality. Neither the levels of arterial blood gas values measured immediately before invasive mechanical ventilation was initiated nor the burden of comorbidity were strong determinants of long-term mortality among these patients.
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Letter Case Reports
Endotracheal tube obstruction secondary to oral medication.