Current opinion in anaesthesiology
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Curr Opin Anaesthesiol · Feb 2007
ReviewWhich device should be considered the best for lung isolation: double-lumen endotracheal tube versus bronchial blockers.
This review is a clinical comparison between double-lumen endotracheal tubes and bronchial blockers to determine which device is considered the best for lung isolation. ⋯ Double-lumen endotracheal tubes and bronchial blockers should be part of the armamentarium of every anesthesiologist involved in lung isolation techniques and every device should be tailored to specific case needs.
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Curr Opin Anaesthesiol · Feb 2007
ReviewNon-antiarrhythmic agents for prevention of postoperative atrial fibrillation: role of statins.
Atrial fibrillation is the most common arrhythmia following cardiac surgery, having both serious medical and socioeconomic consequences. Although there are established antiarrhythmic agents for preventing and treating postoperative atrial fibrillation, these therapies are neither 100% reliable, nor without risks and limitations. Thus, there remains a strong need for non-antiarrhythmic, adjunctive therapies for the prevention of postoperative atrial fibrillation. ⋯ Perioperative statin therapy may represent an important non-antiarrhythmic, adjunctive therapeutic strategy for the prevention of postoperative atrial fibrillation.
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To report the impact of atelectasis on perioperative outcomes. Atelectasis occurs in the dependent parts of the lungs of most patients who are anesthetized. Development of atelectasis is associated with decreased lung compliance, impairment of oxygenation, increased pulmonary vascular resistance and development of lung injury. Here, we examine the etiology, contributing factors, consequences, diagnosis and treatment of atelectasis. ⋯ Atelectasis in the presence of preexisting lung disease or limited cardiopulmonary reserve may have significant consequences. Increasing understanding of the underlying nature of atelectasis and its contribution to acute lung injury will improve our approach to the prevention and management of atelectasis.
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Rapid atrial arrhythmias affect the elderly who undergo cardiac or noncardiac operations annually and have been associated with prolonged hospital stays. This article focuses on new issues leading to the improved understanding of the pathophysiology and mechanisms of postoperative atrial arrhythmias. ⋯ Recent approaches directed at prophylaxis and acute therapy of atrial arrhythmias are discussed as are recommendations to prevent thromboembolic events.
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Curr Opin Anaesthesiol · Feb 2007
EditorialManagement of the patient with a large anterior mediastinal mass: recurring myths.
This editorial review summarizes the current anesthetic management of patients with anterior mediastinal masses. ⋯ General anesthesia is not safe in patients with severe positional symptoms from an anterior mediastinal mass. With modern imaging techniques, general anesthesia is rarely needed for diagnostic procedures in these patients. Preoperative flow-volume loops are not useful in the management of these patients and the concept of cardiopulmonary bypass on 'standby' is not appropriate during induction of anesthesia.