Anaesthesia and intensive care
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Anaesth Intensive Care · Mar 2009
ReviewVideo and optic laryngoscopy assisted tracheal intubation--the new era.
With advances in technology, videoscopy and optic intubation have been gaining popularity particularly in patients with difficult airways or as rescue devices in failed intubation attempts. Their routine use is, however an uncommon occurrence. This review paper will summarise some of those newly developed devices currently available to assist tracheal intubation, their advantages, disadvantages when compared with the conventional laryngoscope and finally, evidence to support their use in both elective and emergency airway management.
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Anaesth Intensive Care · Mar 2009
Randomized Controlled TrialIntraoperative ketamine may influence persistent pain following knee arthroplasty under combined general and spinal anaesthesia: a pilot study.
We report the findings of a randomised controlled triple-blind pilot study of intraoperative ketamine infusion combined with spinal anaesthesia on the prevalence of persisting post surgical pain following total knee arthroplasty surgery. Twelve patients were randomised to receive either ketamine or placebo in association with spinal anaesthesia for total knee arthroplasty. ⋯ Perioperative data collected during the study suggested that the addition of intraoperative ketamine might also improve the quality of recovery. Although no statistical analysis was undertaken due to the small numbers, these preliminary findings suggest that the use of intraoperative systemic ketamine in association with spinal anaesthesia for the reduction of persisting post surgical pain deserves further study.
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Anaesth Intensive Care · Mar 2009
A national survey on the practice and outcomes of mechanical ventilation in Korean intensive care units.
A study was undertaken to describe the practice and outcomes of mechanical ventilation throughout Korea. This prospective cohort study was conducted over a three-month period enrolling patients (n = 519) who received mechanical ventilation for more than 72 hours in 21 university hospital intensive care units throughout Korea. The most common indication for mechanical ventilation was acute respiratory failure. ⋯ In Korean intensive care units, tuberculous lung disease remains an important cause for mechanical ventilation. The practice of mechanical ventilation in Korean intensive care units in general appeared to comply with the current international recommendations with regard to lung protection and weaning. However, intensive care units lacking critical care physicians seemed to be adopting fewer ancillary measures, such as deep vein thrombosis prophylaxis.
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Anaesth Intensive Care · Mar 2009
Outcome of patients receiving high dose vasopressor therapy: a retrospective cohort study.
The aim of this study was to determine the hospital survival of patients receiving high doses of catecholamines. A retrospective observational study was conducted in a 22-bed multidisciplinary adult intensive care unit of a tertiary referral university hospital. All patients (n = 64) receiving > 100 microg/min of adrenaline or noradrenaline or adrenaline and noradrenaline combined over a one-year period were studied to determine survival to intensive care unit and hospital discharge. ⋯ None of the 32 patients who received > 200 microg/min noradrenaline survived. We conclude that the survival of patients requiring high doses of catecholamines is poor but the use of such doses is probably not futile. It remains for individual clinicians, patients and their surrogates to decide whether use of high doses of vasopressor is appropriate, given the low probability of survival.
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Anaesth Intensive Care · Mar 2009
Case ReportsA patient with intractable posthypoxic myoclonus (Lance-Adams syndrome) treated with sodium oxybate.
Posthypoxic myoclonus is a rare and devastating complication of near-fatal cardiopulmonary arrest. Despite treatment with available anti-myoclonic agents, some patients may recover cognitively but remain completely disabled by severe myoclonus. We report a 16-year-old patient with severe treatment-refractory posthypoxic myoclonus, which improved markedly with administration of the drug sodium oxybate.