Articles from Anaesthesia and intensive care 2008 September

Anaesth Intensive Care · Sep 2008

Clinical Trial

Non-invasive cardiac output measurement using a fast mixing box to measure carbon dioxide elimination.

This study investigated the accuracy of a new technique for measuring cardiac output using the derivative Fick principle based on the ratio of change in the partial pressures of end-tidal and mixed expired carbon dioxide produced by short periods of partial rebreathing. A prospective clinical study involving 24 patients following cardiopulmonary bypass for coronary artery bypass grafting or valvular surgery was undertaken in the intensive care unit of a university-affiliated hospital. Haemodynamic measurements were performed after admission to the intensive care unit. ⋯ Cardiac output measurement using the new technique demonstrated a significant but consistent underestimate, with a bias of -0.60 +/- 0.87 l/min. This new adaptation of the partial rebreathing technique is reliable in measuring cardiac output in postoperative patients. Reasons for the consistent discrepancy between thermodilution and partial rebreathing techniques are discussed.

An audit of perioperative cardiac arrests in a Southeast Asian university teaching hospital over 15 years.

An audit of the incidence, causes and outcome of perioperative cardiac arrest was conducted in a university hospital in Pakistan. All perioperative cardiac arrests from induction of anaesthesia to post anaesthesia care unit discharge or intensive care unit admission during noncardiac surgery, from January 1992 to December 2006 were included. Patients' demographic information, physical status and type of surgery and anaesthesia were noted. ⋯ The number of perioperative cardiac arrests and their mortality was higher in patients with poor physical status and in emergency surgery. The number was also higher in infants, patients above 60 and females. The majority of the cases were considered avoidable, indicating the importance of prevention strategies.

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Anaesth Intensive Care · Sep 2008

Dreaming and recall during sedation for colonoscopy.

Dreaming is reported by one in five patients who are interviewed on emergence from general anaesthesia, but the incidence, predictors and consequences of dreaming during procedural sedation are not known. In this prospective observational study, 200 patients presenting for elective colonoscopy under intravenous sedation were interviewed on emergence to determine the incidences of dreaming and recall. Sedation technique was left to the discretion of the anaesthetist. ⋯ Frank recall of the procedure was reported by 4% of the patients, which was consistent with propofol doses commensurate with light general anaesthesia. The only significant predictor of recall was lower propofol dose. Satisfaction with care was generally high, however dreamers were more satisfied with their care than non-dreamers.