Journal of clinical anesthesia
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Randomized Controlled Trial
The effects of thoracic epidural blockade on ventilation-perfusion matching during one-lung ventilation: An exploratory study.
Electrical impedance tomography (EIT) enables continuous image acquisition, facilitating real-time measurements of ventilation and perfusion at the clinical bedside. Experimental and clinical studies on controversial effects of thoracic epidural blockade (TEB) with local anesthetics on ventilation-perfusion(V/Q) matching and hypoxia during one lung ventilation (OLV) are rare. The aim of this study was to use EIT to investigate the effects of TEB combined with general anesthesia on pulmonary perfusion distribution and V/Q matching during one-lung ventilation. ⋯ Based on the contrast-enhanced EIT evaluation of pulmonary perfusion and ventilation, TEB appears to induce a V/Q mismatch in patients undergoing OLV in the lateral position for thoracic surgery.
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Randomized Controlled Trial
Effect of inspiratory oxygen fraction during driving pressure-guided ventilation strategy on pulmonary complications following open abdominal surgery: A randomized controlled trial.
The aim of the present study was to determine the effect of 30 % fraction of inspired oxygen (FIO2) compared with 80 % FIO2 in the context of driving pressure-guided ventilation strategy on pulmonary complications following open abdominal surgery. ⋯ In patients undergoing open abdominal surgery, using a 30 % FIO2, compared with 80 % FIO2, in context of driving pressure-guided ventilation strategy, intraoperatively reduced the incidence and severity of pulmonary complications within the first 7 postoperative days.
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Randomized Controlled Trial
Continuous vital sign monitoring on surgical wards: The COSMOS pilot.
Alerts for vital sign abnormalities seek to identify meaningful patient instability while limiting alarm fatigue. Optimal vital sign alarm settings for postoperative patients remain unknown, as is whether alerts lead to effective clinical responses reducing vital sign disturbances. We conducted a 2-phase pilot study to identify thresholds and delays and test the hypothesis that alerts from continuous monitoring reduce the duration of vital sign abnormalities. ⋯ gov registration: NCT05280574.
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Randomized Controlled Trial
Impact of deep neuromuscular blockade on intraoperative NOL-guided remifentanil requirement during desflurane anesthesia in laparoscopic colorectal surgeries: A randomised controlled trial.
Evaluate the impact of deep neuromuscular blockade on intraoperative nociception Deep neuromuscular blockade has been shown to improve surgical conditions and postoperative outcomes compared to moderate neuromuscular blockade in laparoscopic surgery. Still, its impact on intraoperative nociception and opioid requirement has never been assessed. ⋯ This study shows that deep neuromuscular blockade reduces intraoperative NOL-guided administration of remifentanil in colorectal laparoscopic surgeries. It also improves surgical conditions.
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Observational Study
Impact of emergence delirium on long-term survival in older patients after major noncardiac surgery: A longitudinal prospective observational study.
To test the hypothesis that emergence delirium might be associated with worse long-term survival. ⋯ www.chictr.org.cn; ChiCTR-OOC-17012734.