Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Apr 2012
ReviewDesflurane: a clinical update of a third-generation inhaled anaesthetic.
Available volatile anaesthetics are safe and efficacious; however, their varying pharmacology provides small but potentially clinically important differences. Desflurane is one of the third-generation inhaled anaesthetics. It is the halogenated inhaled anaesthetic with the lowest blood and tissue solubilities, which promotes its rapid equilibration and its rapid elimination following cessation of administration at the end of anaesthesia. ⋯ In addition, the use of desflurane promotes early and predictable extubation, and the ability to rapidly transfer patients from the operating theatre to the recovery area, which has a positive impact on patient turnover. Desflurane also increases the likelihood of patients, including obese patients, recovering their protective airway reflexes and awakening to a degree sufficient to minimise the stay in the high dependency recovery area. The potential impact of the rapid early recovery from desflurane anaesthesia on intermediate and late recovery and resumption of activities of daily living requires further study.
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Acta Anaesthesiol Scand · Apr 2012
Reliability and validity of the Swedish version of the modified Yale Preoperative Anxiety Scale.
The modified Yale Preoperative Anxiety Scale (m-YPAS) is an observational behavioral checklist that has been widely used as an indicator of pre-operative anxiety in children. The present study describes the translation process of m-YPAS into Swedish and the testing of its reliability and validity when used with Swedish children. ⋯ This validation study of the Swedish version of the m-YPAS shows good consistency, interrater validity, and construct validity when used by experienced assessors.
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Acta Anaesthesiol Scand · Apr 2012
Comparative StudyLack of agreement and trending ability of the endotracheal cardiac output monitor compared with thermodilution.
Minimally invasive monitoring systems of central haemodynamics are gaining increasing popularity. The present study investigated the precision of the endotracheal cardiac output monitor (ECOM) system and its agreement with pulmonary artery catheter thermodilution (PAC TD) for measuring cardiac output (CO) during steady state and with induced haemodynamic changes in patients scheduled for elective cardiac surgery. ⋯ In a direct comparison with PAC TD, the ECOM system did not show an acceptable agreement, with wide limits of agreement, a much larger percentage error than should be expected from the precision of the two methods and a very poor trending ability. Thus, the ECOM does not replace measurements done by thermodilution using a pulmonary artery catheter in cardiac surgery patients.
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Acta Anaesthesiol Scand · Apr 2012
Outcome of spontaneous and iatrogenic pneumothoraces managed with small-bore chest tubes.
Little is known about the efficacy of management of iatrogenic pneumothoraces with small-bore chest tubes. The aim of this study was to assess the outcome of iatrogenic pneumothoraces requiring drainage managed with a small-bore chest tube and to compare the results to spontaneous pneumothoraces treated in the same unit with the same device. The primary outcome was requirement of video-assisted thoracoscopic surgery for drainage failure; secondary outcomes were length of drainage and number of inserted chest tubes. ⋯ Small-bore chest tubes are feasible for treatment of iatrogenic pneumothoraces and have a better rate of success and slightly longer drainage duration than when used for spontaneous pneumothoraces.
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Acta Anaesthesiol Scand · Apr 2012
Lactate levels predict mortality and need for peritoneal dialysis in children undergoing congenital heart surgery.
The purpose of this study was to investigate whether an initial post-operative lactate level is a predictor of mortality, need for peritoneal dialysis (PD), duration of intubation or length of stay (LOS) in the intensive care unit (ICU) in children undergoing cardiac surgery. ⋯ The initial post-operative lactate level was a predictor of mortality and need for PD in children undergoing surgery for congenital heart disease.