Canadian journal of anaesthesia = Journal canadien d'anesthésie
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To study the feasibility of using the Pro-Seal laryngeal mask airway (LMA) for airway maintenance during bronchoscopic guided percutaneous tracheostomy. ⋯ The Pro-Seal LMA provides a reliable airway and allows effective ventilation during percutaneous tracheostomy. The passage of a fibrescope through the Pro-Seal LMA and glottis is easy and provides a clear view of the upper trachea.
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Review
The therapeutic use of magnesium in anesthesiology, intensive care and emergency medicine: a review.
To review current knowledge concerning the use of magnesium in anesthesiology, intensive care and emergency medicine. ⋯ Magnesium has many known indications in anesthesiology and intensive care, and others have been suggested by recent publications. Because of its interactions with drugs used in anesthesia, anesthesiologists and intensive care specialists need to have a clear understanding of the role of this important cation.
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The first criteria for the determination of brain death were developed in 1968 in part to address concerns that had arisen with the retrieval of organs for transplantation. Despite over 30 years of application, some professional and public doubt persists over the validity of the theoretical construct underlying this method of determining death. Our review will address historical perspectives on the development of brain death criteria, and inconsistencies in current clinical criteria. ⋯ Organ transplantation is premised on professional and public acceptance that the donor is dead. Given that the criteria for brain death or their application remain variable, we suggest that it is reasonable to consider a national consensus to address these inconsistencies. Alternatively, the standard use of confirmatory radiographic testing prior to the retrieval of organs from donors who meet clinical brain death criteria should be considered to provide conclusive evidence of permanent and irreversible loss of brain function.
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Randomized Controlled Trial Clinical Trial
Nitrous oxide produces minimal hemodynamic changes in patients receiving a propofol-based anesthetic: an esophageal Doppler ultrasound study.
Nitrous oxide (N(2)O) is a frequently used adjunct to propofol anesthesia. Although N(2)O reduces the requirement of propofol for induction and maintenance, the effects of both drugs on overall hemodynamics remain controversial. We tested the hypothesis that the addition of N(2)O to therapeutic doses of propofol alters hemodynamics and Doppler-derived variables evaluated with the esophageal Doppler monitor in a randomized, double-blinded, placebo-controlled design. ⋯ Propofol causes dose-dependent decreases in ABF and MAP; however, 70% N(2)O produces minimal hemodynamic and Doppler-derived variable changes under target-controlled propofol infusion at therapeutic concentrations.
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Randomized Controlled Trial Comparative Study Clinical Trial
The gum elastic bougie eases tracheal intubation while applying cricoid pressure compared to a stylet.
To compare the ease of tracheal intubation facilitated by the gum elastic bougie or the malleable stylet while applying cricoid pressure. ⋯ Applying cricoid pressure worsened laryngeal view. The use of a gum elastic bougie was more effective than the use of a stylet to facilitate intubation.