Journal of neurosurgical anesthesiology
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J Neurosurg Anesthesiol · Jan 2013
Real-time multimodal axillary vein imaging enhances the safety and efficacy of axillary vein catheterization in neurosurgical intensive care patients.
Controversy exists regarding the increased safety profile when ultrasound is used for central venous catheters inserted in the subclavian or axillary vein. The critically ill neurosurgical patient presents unique considerations for the optimal central line approach. ⋯ This series illustrates new and useful aspects of ultrasound use in transpectoral axillary vein catheterization: it requires minimal additional training; it combines the real time, in-plane technique with transverse, longitudinal, and Doppler color flow images; and it is used safely in the critically ill neurosurgical patient. The data on infraclavicular central venous catheters indicate decreased line sepsis, arterial punctures, and venous thrombosis while improving nursing care and patient comfort. This technique's potential for decreasing the risk of pneumothorax may make it a reasonable option for many critically ill patients in whom other central venous catheter approaches may not be ideal.
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J Neurosurg Anesthesiol · Jan 2013
A combination of sevoflurane postconditioning and albumin increases Bcl-2 expression after transient global cerebral ischemia compared with either sevoflurane postconditioning or albumin alone.
The aim of this study was to determine whether a combination of sevoflurane postconditioning and albumin provides additive neuroprotective effects after transient global cerebral ischemia in rats. ⋯ A combination of sevoflurane postconditioning and albumin increased the level of Bcl-2 expression compared with sevoflurane postconditioning or albumin alone, suggesting their combination might provide additional neuroprotection by decreasing apoptosis.
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J Neurosurg Anesthesiol · Jan 2013
Letter Case ReportsBone embolism during neurosurgery in sitting position.