Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Mar 2005
Comparative StudyAcceleromyography vs. electromyography: an ipsilateral comparison of the indirectly evoked neuromuscular response to train-of-four stimulation.
There is a considerable body of evidence which suggests that data obtained using acceleromyography (AMG) cannot be used interchangeably with observations obtained by mechanomyographic (MMG) or electromyograhic (EMG) methods. All previous such studies evaluated the responses from contralateral limbs. This investigation was undertaken to determine if these previously described differences were in part a function of observing the responses from opposing limbs. ⋯ Acceleromyographic TOF values tend to overestimate the extent of EMG recovery. Acceleromyographic TOF values <0.90 are indicative of incomplete neuromuscular recovery.
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Acta Anaesthesiol Scand · Mar 2005
Vasodilatory shock in severe acute pancreatitis without sepsis: is there any place for hydrocortisone treatment?
Hydrocortisone (HC) has been reported to rapidly improve hemodynamics and reduce the time to vasopressor cessation in septic shock, but none has focused on this effect in acute pancreatitis. We therefore performed a study to assess the effects of hydrocortisone on catecholamine-dependent shock among patients with severe acute pancreatitis. ⋯ According to our data it seems reasonable to formulate a hypothesis that low doses of HC shorten the time to vasopressor cessation and rapidly reduce the need for norepinephrine support in patients with shock associated with severe acute pancreatitis without sepsis.
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Acta Anaesthesiol Scand · Mar 2005
Comparative Study Clinical TrialArtificial colloids impair haemostasis. An in vitro study using thromboelastometry coagulation analysis.
Hydroxyethyl starch (HES) solutions impair haemostatic mechanisms. The impact of the degree of substitution (DS) of a HES solution on thromboelastometry tracings is unclear. Therefore we tested the hypothesis of whether the DS has an effect on the haemostatic defect caused by HES, and assessed whole blood coagulation by thromboelastometry coagulation analysis (ROTEM, Pentapharm Co., Munich, Germany) in serial in vitro haemodilutions of colloids. ⋯ In vitro the impact of the degree of substitution of HES solution on thromboelastometry coagulation analysis was modest. Haemodilution with gelatin and albumin induced fewer coagulation abnormalities than HES. In addition, the haemodilution with gelatin impaired coagulation more than albumin solution.
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Acta Anaesthesiol Scand · Mar 2005
Case ReportsUse of a new supraglottic airway device--the CobraPLA--in a 'difficult to intubate/difficult to ventilate' scenario.
A 67-year-old male was scheduled for cadaveric renal transplant. Following rapid sequence anaesthesia, only the tip of the epiglottis was visualized. Mask ventilation was difficult, and therefore an alternative airway device was considered. ⋯ Then, a size 7 endotracheal tube was threaded over a fiberoptic bronchoscope, through the CobraPLA, into the trachea. The description and insertion technique of the CobraPLA, a new supraglottic airway device is shortly discussed. This is the first report of successful management of difficult mask ventilation with the new CobraPLA, supraglottic airway device.