Anaesthesia and intensive care
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Anaesth Intensive Care · Jun 2001
Case ReportsVentilator-patient dyssynchrony induced by change in ventilation mode.
Patient-ventilator interactions may be coordinated (synchronous) or uncoordinated (dyssynchronous). Ventilator-patient dyssynchrony increases the work of breathing by imposing a respiratory muscle workload. ⋯ We describe a case of severe patient-ventilator dyssynchrony and hypothesize that dyssynchrony was induced by a change in mode of ventilation from pressure-cycled to volume-cycled ventilation, due to both ventilator settings and by the patient's own respiratory centre adaptation to mechanical ventilation. The causes, management and clinical implications of dyssynchrony are discussed.
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Anaesth Intensive Care · Jun 2001
Do anaesthetized patients recover better after Bispectral Index Monitoring?
Could Bispectral Index (BIS) monitoring during anaesthesia improve the recovery characteristics of patients? Previous studies have shown conflicting results. To eliminate bias, a control group of 75 cases anaesthetized by the authors was compared to a reference group of 141 cases anaesthetized by other anaesthetists. A study group of 71 cases was then anaesthetized by the authors titrating to BIS 40-50 and this was compared with the control group. ⋯ Activity and consciousness levels were higher on arrival in PACU in the BIS monitored group (P = 0.015 and P = 0.017) but were not maintained. There was no significant difference in mean oxygen saturation scores. The improved recovery characteristics in BIS monitored patients may have positive implications for safety, nursing workload, staffing, and cost savings in the PACU.
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Anaesth Intensive Care · Jun 2001
Case ReportsAirway protection with the ProSeal laryngeal mask airway.
The ProSeal laryngeal mask airway is a new laryngeal mask device that has a modified cuff and a drainage tube. We describe a case where the ProSeal laryngeal mask successfully channelled regurgitated fluid away from the respiratory tract.