Journal of clinical anesthesia
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Case Reports
The laryngeal mask airway for awake craniotomy in the pediatric patient: report of three cases.
The anesthetic management of three pediatric patients who underwent awake craniotomy with a combined, continuous intravenous infusion of propofol and alfentanil is described. The Laryngeal Mask Airway was effective in airway management during resection of epileptic foci with intraoperative cortical mapping and neuropsychological (speech) evaluation.
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Fiberoptic-compatible oral airways (FCOAs) combine the simplicity and benefits that traditional oral airways provide, with the advantage of mechanically guiding fiberoptic intubation. This review examines and compares the salient properties of these devices. Of note, the clinician should pay particular attention to the location and depth of the channel. ⋯ Furthermore, because of its size, the iLMA can potentially cause airway trauma, which could subsequently limit the utility of a fiberscope. In addition, the FCOA can generate greater positive-pressure ventilation, when used with a tight-fitting face mask, than the iLMA. FCOAs offer clinicians the ability to visualize airway anatomy while allowing straightforward access for tracheal intubation.
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Randomized Controlled Trial Clinical Trial
Influence of crystalloid and colloid replacement solutions on hemodynamic variables during acute normovolemic hemodilution.
To determine whether, in maintaining normovolemia during acute normovolemic hemodilution, replacement fluid choice influences intraoperative hemodynamic variables. ⋯ During hemodilution, anesthetized patients maintain whole body oxygenation by increasing oxygen extraction. The administration of hetastarch or dextran as the replacement fluid during acute normovolemic hemodilution is associated with a more stable mean arterial pressure, but overall acute normovolemic hemodilution is well tolerated irrespective of the replacement fluid used.
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To evaluate a point-of-care (POC) coagulation monitoring analyzer (CoaguChek Pro DM) in patients undergoing cardiopulmonary bypass (CPB). ⋯ CoaguChek Pro DM is a reliable and time-efficient point-of-care system for monitoring coagulation of patients undergoing CPB. The use of this system may improve patient care in this group through timely and accurate clinical decisions.
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To investigate the effect of intraoperative leukocyte reduction of administered blood products on the incidence of acute cellular rejection and postoperative patient outcome. ⋯ Coincident with leukocyte reduction of all administered blood products during OLT, an improved outcome was observed in Group 1 patients as demonstrated by both a decreased incidence of acute cellular rejection and length of hospital stay.