Anaesthesia and intensive care
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Anaesth Intensive Care · Oct 1997
Multicenter StudyAnalgesia following thoracotomy: a survey of Australian practice.
This survey examines pain management after thoracotomy in Australian hospitals. Questionnaires were sent to senior thoracic anaesthetists at 27 hospitals (16 public and 11 private) with thoracic surgical units. Twenty-six anaesthetists replied and 24 responses were included in the analyses. ⋯ Over half of the respondents reported that post-thoracotomy patients are nursed in a high-dependency area. Seventy-nine percent of respondents selected epidural analgesia as the best available analgesia technique, whereas 21% consider IVPCA to be the best. Only 75% of respondents reported that the type of analgesia they consider best is also the type which they use most frequently.
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A study was conducted in an attempt to devise a simple and more accurate method of predicting difficult intubation. Prospective assessments were made in 282 patients and retrospective assessment in 16 patients with regard to 21 anatomical factors which were correlated with the laryngoscopic view at intubation. Twelve factors correlated significantly with difficult intubation. ⋯ A scoring system was devised, assigning points to each variable based on its discriminative value. A score of 6 or more correctly identified 22 out of the 23 difficult intubations and there were 50 false positives (sensitivity, specificity and PPV of 96%, 82% and 31% respectively). When negative scoring was done for factors favouring easy intubation, false positives were reduced to 36, but only 20 difficult cases could be identified correctly.
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Anaesth Intensive Care · Oct 1997
Comment Letter Case ReportsFatal outcome after propofol sedation in children.
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Anaesth Intensive Care · Oct 1997
Randomized Controlled Trial Comparative Study Clinical TrialVentilator-CPAP with the Siemens Servo 900C compared with continuous flow-CPAP in intubated patients: effect on work of breathing.
The effects of continuous positive airway pressure (CPAP) provided by the Siemens Servo 900C ventilator were compared with a continuous flow system (CF-CPAP) in patients weaning from the ventilator. Thirteen patients were studied using both systems at a CPAP level of 0.5 kPa. Additional work of breathing (Wapp) and derived variables were determined in relation to the minute volumes of the patients. ⋯ The EEP increasingly exceeded the preset CPAP level of the ventilator at higher minute volumes. An inspiratory threshold due to a gradient between EEP and preset CPAP greatly increased the Wapp imposed by the ventilator. As this threshold was attributed to the resistance of the PEEP device of the ventilator, it indicates that the additional work related to the expiratory value should be taken into account when the Siemens Servo 900C ventilator is used for weaning purposes.