Canadian journal of anaesthesia = Journal canadien d'anesthésie
-
Comparative Study
End-tidal carbon dioxide measurements in critically ill neonates: a comparison of side-stream and mainstream capnometers.
To determine whether end-tidal PCO2 (PETCO2) measurements obtained with two infrared capnometers accurately approximates the arterial PCO2 (PaCO2) in critically ill neonates, simultaneous measurements of PETCO2 were obtained from the distal and proximal ends of the tracheal tube with a sidestream capnometer (Puritan Bennett/Datex--BP/D) and from the proximal end with a mainstream capnometer (Hewlett-Packard-HP) in 20 intubated neonates. Distal sidestream PETCO2 and mainstream PETCO2 correlated with the PaCO2 (r2 = 0.66 and 0.61, respectively) within the range of 26-57 mmHg PaCO2. However, proximal PETCO2 with the sidestream capnometer correlated very poorly (r2 = 0.09) with PaCO2. ⋯ The slope of the regression for the proximal sidestream capnometer did not differ significantly from horizontal. Insertion of the mainstream sensor for the HP capnometer significantly increased the transcutaneous CO2 when compared with preinsertion values. We conclude that both distal sidestream and mainstream capnometry provide accurate estimates of the PaCO2 in critically ill neonates.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Rapid induction sequence with vecuronium: should we intubate after 60 or 90 seconds?
The purpose of the study was to determine intubating conditions after administration of either succinylcholine or vecuronium in a rapid induction sequence. Patients received either succinylcholine 1.5 mg.kg-1 (Groups I and II) after d-tubocurarine 0.05 mg.kg-1 four minutes earlier, or vecuronium (Groups III and IV) in an initial dose of 0.01 mg.kg-1 followed four minutes later by 0.1 mg.kg-1. In Groups I and III an apnoeic delay of one minute was allowed before intubation whereas in Groups II and IV the delay was 90 sec. ⋯ A delay of 90 sec after succinylcholine improved intubating conditions in male patients. Considering that intubating conditions obtained after 90 sec in patients given a priming sequence with vecuronium (Group IV) were not different from those obtained 60 sec after succinylcholine (Group I), the authors conclude that vecuronium is an acceptable alternative for rapid tracheal intubation. In the doses used in this study, intubating conditions 60 sec after vecuronium were unacceptable for rapid induction of anaesthesia.