Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Sep 2002
Design evaluation of commonly used rigid and levering laryngoscope blades.
The shape of a laryngoscope blade affects the exposition of the larynx. This study evaluates and compares some rigid and levering blade designs based on previous investigative X-ray laryngoscopic studies. ⋯ The difference in shape and design of Macintosh blades affects their performance. The distal portion of a large-sized curved blade is more effective than the full length of a shorter blade. The #4 English Macintosh is a better choice for routine clinical use. The Flexiblade performs as a multiblade device and can therefore be used for both routine and difficult intubations.
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Acta Anaesthesiol Scand · Sep 2002
Accuracy of point-of-care-testing (POCT) for determining hemoglobin concentrations.
While point-of-care testing (POCT) is being used increasingly as a basis for deciding on perioperative erythrocyte transfusion, no valid standards currently exist concerning the accuracy of Hb concentration measurements. For clinical employment, however, the confidence limits (+/-2 SD) of these measurements should lie close to 5 g/l. The aim of the present study was to evaluate the accuracy and precision of point-of-care testing for blood hemoglobin concentration (cHb in g/l) measurements in critically ill patients. ⋯ The above-stated requirement for POCT systems, i.e. that the confidence limits should lie close to 5 g/l cHb, held true for the dry heparinized samples of the blood gas analyzer (1st measurement and mean of 2), the HemoCue system (mean of 3) and the automated hematology analyzer.
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The incidence of withholding and withdrawing life support from the critically ill has increased in recent years. The aim of this study was to assess the degree of consistency between the weight assigned by intensivists to different determinants and their relation to end-of-life decisions, and to evaluate the current concepts in withholding or withdrawing intensive care in Nordic countries. ⋯ No generally accepted grounds for end-of-life decisions could be detected among Nordic intensivists. In addition, the current concept of management after decision to withdraw therapy varies markedly. This study has implications in further assessment of the individual decision-making process and the uniformity of actions after withdrawal decisions.
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Acta Anaesthesiol Scand · Sep 2002
Target-controlled infusion of propofol induction with or without plasma concentration constraint in high-risk adult patients undergoing cardiac surgery.
Calculated plasma (Cp) and calculated effect site concentrations (Ce) of propofol associated with loss of consciousness (LOC) have been studied in young healthy patients. The aim of the study was to evaluate the calculated propofol concentrations required to induce LOC in ASA III adult patients undergoing cardiac surgery using a smooth target controlled infusion of propofol. ⋯ In ASA III patients undergoing cardiac surgery, smooth propofol TCI induction, using the pharmacokinetic set of Marsh et al. incorporated in the Diprifusor, is associated with LOC at a low mean calculated plasma concentration of 1.9 micro g/ml and good hemodynamic stability.